Dizziness 101 E-Class TAKE HOME POINTS

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1 Dizziness 101 E-Class Dizziness is one of the most common reasons people seek medical care Important to consider the inner ear as a cause 5.5: Average number of providers seen if the inner ear wasn t considered as a cause at the initial visit 8: Average number of months to receive an accurate diagnosis when the inner ear isn t considered as a cause vs ONE when the inner ear is considered Dizziness is considered an umbrella or vague term Important to categorize your symptoms Dizziness is an umbrella term What does it mean to YOU? VERTIGO Room spinning In Your Head ( off ; foggy headedness; etc) LIGHT HEADED Faint-like Falling sensation UNSTEADINESS Loss of balance Drunk-like

2 If room spinning vertigo, important to know if: The room is spinning around you, and/or Is it more of a spinning in your head? If you feel light headed, important to know if: Is it faint-like like passing out, and/or A falling or general heaviness throughout your body? If you feel unsteady, important to know if: Is it a feeling of being off a feeling in your head? Drunk-like? And/or an unsteadiness from your feet? Anxiety can also cause light headedness May not be related to position changes (e.g., from sitting to standing or bending over, etc) May also be described as a falling sensation or general heaviness throughout your body Can be accompanied by tingling/numbness in the fingers and/or around the mouth Anxiety results in a true physiological response and, should not be taken lightly Anxiety can cause dizziness and, even more commonly, dizziness can result in anxiety

3 If you feel light headed or faint-like with moving from lying down to sitting sitting to standing, it is important to have your blood pressure checked in various positions If a 20 mmhg drop on the top number between these position changes or a 10 mmhg with the bottom number then You may have orthostatic hypotension ALWAYS seek advice of a health care provider when you have dizziness don t self-diagnose or treat yourself without knowing the cause Let s take a brief break and talk about CHARACTERISTICS of dizziness

4 Important to know What makes it worse? Better? Are your symptoms constant? Or do they fluctuate? How long do your symptoms last Seconds? Minutes? Hours? Days? Are there any patterns Poor sleep? Stress? Allergies? Specific activities? Other illnesses? With hearing changes, fullness in your ears and/or ringing in your ears? 60% of making an accurate diagnosis is from the intake Reviewing your medical history and gathering information about your symptoms If room spinning vertigo, important to know duration (how long) symptoms last SECONDS and POSITIONAL: possibly BPPV (ear crystals dislodged and responds well to specific treatments) MINUTES to HOURS: possibly a fluid problem of the inner ear or migraine related HOURS to DAYS: possibly an inner ear infection, which >95% of the time is a one time occurrence If the room is not spinning but Worse with movement most likely inner ear Worse with head still most likely visual system BUT both of the above could be related to your neck

5 Remember: Important to undergo a comprehensive clinical exam from a vestibular specialist More sophisticated testing can identify things that are not observable in a clinical exam BUT a clinical exam can identify impairments that an MRI, CT scan or even sophisticated inner ear testing cannot Successful treatment begins with a successful diagnosis Let s take a brief break and talk about TREATMENT of dizziness

6 Treatment Everyone is interested in how can you TREAT dizziness Remember people may share symptoms but their recovery and treatment is unique If suspect BPPV (ear crystals) then specific maneuvers are performed with a high success rate in 1-2 visits Treatment for BPPV is NOT an exercise Be cautious if you have been given exercises for BPPV or been asked to repeat the maneuvers daily Everyone is interested in how can you TREAT dizziness Remember people may share symptoms but their recovery and treatment is unique Remember: we treat the person YOU not the diagnosis you should be defined by your diagnosis Treatment for BPPV is NOT an exercise Be cautious if you have been given exercises for BPPV or been asked to repeat the maneuvers daily

7 If not BPPV but you have movement-related dizziness, there are specific exercises that can help Cawthorne-Cooksey exercises do not fall into the category of specific exercises Cawthorne-Cooksey were developed in the 1940 s and we have much more efficient treatment techniques now Be cautious if you have been given Cawthorne- Cooksey exercises for your treatment plan Your symptoms may get worse before they get better BUT Your symptoms shouldn t make you miserable or non-functional Therapy should be guided by What activities increase your symptoms? By how much? And, how quickly do you recover? Although it s important to know about your symptoms There may be times where focusing on your symptoms can actually make you feel worse

8 Remember: Once you have seen one person with dizziness, you have seen one person with dizziness Despite the thousands of patients we have seen in our clinic, each person is unique It is critical to understand what your dizziness means to you Your symptoms help identify the cause and define treatment Treatment must be customized Thank You! We are so grateful for your participation in Dizziness 101. We look forward to your feedback! And, don t forget to join us for our Live Q&A on the 3 rd Tuesday of the month: Talk Tuesdays with VEDA at 4 pm PST Click here to view VEDA facebook page Please check out our other E-Classes. And, if there is a topic you want us to add, please let us know! Thanks, again!!!