THE DIZZY PATIENT

You can experience dizziness in many different ways. Whether you feel the room is spinning or you feel lightheaded, an episode of dizziness can be an unpleasant experience.

THE DIZZY PATIENT

Very often, patients will present to their physician with complaints of paroxysmal vertigo or disequilibrium. Patients often describe their dizziness as a sudden sensation of the room spinning, rocking on a boat, or feeling lightheaded. There are other patients who present with chronic disequilibrium or balance complaints. These patients may feel like they veer to the right or left when walking and suffer from multiple falls. It is important for a physician to obtain a proper diagnosis so he/she may prescribe an appropriate treatment plan.

 

For the patients that present with paroxysmal episodes, the differential diagnosis typically includes cardiogenic/cardiovascular etiologies, Meniere’s disease, migraine, or BPPV. It is often very difficult for the physician to identify the correct diagnosis in this list of differentials as the patient often is not available for direct physician review when they are symptomatic. In addition to the patient’s history, physical exam, which may be focused on either neurologic or otologic in nature, hearing and vestibular tests, direct review of any abnormal eye movements called nystagmus is extremely important to help lock in a proper diagnosis; particularly when the patient is most symptomatic. Certain pathological eye movement patterns that physicians should be aware of are associated with Meniere’s disease or migraine exacerbation and other pathologic gravity dependent eye movements that are often caused by dislodged crystalline debris in the inner ear. This diagnosis is called benign paroxysmal positional vertigo (BPPV).

 

If a patient is able to obtain a recording of his/her eye movements during a paroxysmal episode of vertigo or disequilibrium using the Vertigo Recording Goggles (VRG), this recording can later be used by his/her physician to help make a more accurate diagnosis for the patient. Once the patient presents these recordings to his/her physician, the physician can then analyze the nystagmus patterns to better understand the underlying pathology of his/her dizziness. Each diagnosis—whether it is Meniere’s disease, migraine, BPPV, or a cardiovascular/cardiogenic etiology—requires a different form of treatment strategy to help the patient. With the useful data the eye recordings can provide, the physician can ensure each patient is getting an optimal treatment plan.