Blog | Saturday, April 21, 2012

Vertigo, or how I diagnosed myself at Internal Medicine 2012


Have you ever felt inexplicably dizzy? Chances are that sometime you will, according to neurotologist Michael Teixido, MD.

 “Almost everyone in this room will see a doctor at some point because they are dizzy,” he said at the start of his Internal Medicine 2012 session. Which made me feel a little better that I had picked to cover his lecture in an attempt to learn something about my own vertigo-- it's like I was seeing a doctor, just without the hassle of scheduling and payment.

I should probably add some caveat that ACP scientific sessions are not intended for self-diagnosis by lay people, but hey, this time it worked. Turns out I had benign paroxysmal positional vertigo (BPPV), which also happens to be the most common cause of dizziness (25% of overall complaints). It's easy to diagnose and treat, too. Use the Hallpike maneuver to diagnose and Brandt-Daroff exercises to treat.

The next most common causes of vertigo are migraine-associated vertigo, vestibular neuronitis and Meniere's disease. Since they didn't apply to me, I paid slightly less attention, but I did pick up a few pearls:

Migraine vertigo works a lot like migraines, with triggers and patients having a sense that it's coming on, and can be treated with the same kinds of prophylaxis. And don't think people don't have it just because they don't meet the official criteria for migraine, Dr. Teixido said.

On vestibular neuronitis-- patients will initially need meclizine, but only give one prescription with no refills, because given a chance, the body will correct the problem itself. Dr. Teixido said he's taken patients off the drug who have been on it for 30 years.

Nobody knows what causes Meniere's disease, but it seems like it might be related to migraines.