balance disorders
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Truths About Vertigo & Balance Disorders
By Dr. A. R. Scopelliti
Truths about vertigo & balance disorders.
23 things you might not know about vertigo, dizziness and balance disorders
· In 1994, 11 million physician visits for dizziness were recorded.
· In 1988, Dysequilibrium was the second most common diagnosis for a Medicare hospital admission, with an average stay of 4.3 days.
· 50% of patients complaining of dizziness in a primary care setting do not get a diagnosis.
· 70% of patients complaining of dizziness in a primary care setting get a prescription for Meclizine.
· Meclizine is known to hinder the natural vestibular compensation process.
· Most medication geared towards treating the symptoms of dizziness and dysequilibrium (vestibular suppressant, anti-emetics, anti-cholinergics, sedatives, and tranquilizers) hinder the natural vestibular compensation process.
· Meclizine has the slowing effect on reaction time equal to a blood alcohol level of .04 to .06.
· Reduced reaction time is a leading cause of falls in the elderly.
· Vestibular abnormalities are found in 50 percent of fallers.
· Falls lead to over 200,000 hip fractures per year in the U.S.
· Nearly 50% of elderly patients admitted for hip fractures become chronic patients.
· Nearly 50% of elderly patients admitted for hip fractures die within one year.
· MRI exams have a very low yield for patients undergoing examinations for dizziness.
· Vestibular evaluations including auditory evoked potentials and electronystagmography are over 90% sensitive for auditory nerve, brainstem or cerebellar pathology causing dizziness.
· Vestibular evaluation generally costs about one half of a MRI with contrast.
· All that is dizzy is not vestibular. Visual and Somatosensory input, as well as efficient brainstem integration also contributes to normal balance function.
· Approximately 1000 medications in the PDR list dizziness, vertigo, or light-headedness as a possible side effect.
· Vestibular disorders are responsible in 85% of patients complaining of dizziness.
· Benign paroxysmal positional vertigo (BPPV) is the most common cause: of episodic vertigo.
· BPPV is treated successfully in one or two office sessions over 90% of the time.
· In patients with chronic balance problems, only vestibular rehabilitation has shown to improve balance function and performance when compared to medical therapy or general exercises.
· Therapy directed towards a specific diagnosis resulted in resolution of symptoms in 85% of patients, while general vestibular rehabilitation exercises resulted in complete resolution in only 64%.
· There is a high correlation between '"panic disorders" and abnormal vestibular function.
References
Micromedical Technologies, 10 Kemp Drive, Chatham, IL 62629, in the booklet entitled "Dizziness and Balance Disorders", "Evaluation and Treatment": "A Short Course for Primary Care Physicians", second edition", May 2001.
More information is available at www.dcneuro.net
Dr. Scopelliti practices in Long Branch NJ, and is the medical director of Jersey Shore Regional Center for Vertigo, Dizziness and Dystonia, and specializes in the management of individuals suffering with vertigo, dizziness and dystonia disorders, as well as many other neurologic disorders.
http://www.dcneuro.net
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