23 Things You Might Not Know About Dizziness and Balance Disorders

1. In 1994, 11 million physician visits for dizziness were recorded (Nashner).
2. In 1988, dysequilibrium was the second most common diagnosis for a Medicare hospital admission, with an average stay of 4.3 days (Weindruch).
3. More than 70% are treated by primary care doctors (Sloane 1989).
4. Less than 10% of dizzy patients are ever evaluated by a specialist (Otology, Audiology or Neurology) (Sloane 1989).
5. 50% of patients complaining of dizziness in a primary care setting do not get a diagnosis (Squires).
6. 70% of patients complaining of dizziness in a primary care setting get a prescription for Meclizine (Burke).
7. Meclizine is known to hinder the natural vestibular compensation process.
8. 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 (Zee).
9. Meclizine has the slowing effect on reaction time equal to a blood alcohol level of 0.04 to 0.06 (Manning).
10. Reduced reaction time is a leading cause of falls in the elderly (Tideiksaar).
11. Falls lead to over 200,000 hip fractures per year in the U.S. (Haupt & Graves).
12. Nearly 50% of elderly patients admitted for hip fractures become chronic patients (Naylor).
13. Nearly 50% of elderly patients admitted for hip fractures die within one year (Rubenstein).
14. MRI exams have a very low yield for patients undergoing examinations for dizziness (Gizzi).
15. Vestibular evaluations including Auditory Evoked Potentials and Electronystagmography are over 90% sensitive for auditory nerve, brainstem, or cerebellar pathology causing dizziness (Hamid, Kumar).
16. Vestibular evaluation generally costs about one half of an MRI with contrast (Physician Fees, 1996).
17. All that is dizzy is not vestibular. Visual and somatosensory input, as well as efficient brainstem integration also contribute to normal balance function.
18. Approximately 1,000 medications in the PDR list dizziness, vertigo, or light-headedness as a possible side effect (Smith).
19. Vestibular disorders are responsible in over 50% of patients complaining of dizziness (Kroenke et al 2000).
20. Benign Paroxysmal Positioning Vertigo (BPPV) is the most common cause of episodic vertigo (Epley).
21. BPPV is treated successfully in one or two office sessions over 90% of the time.
22. In patients with chronic balance problems, only vestibular rehabilation has shown to improve balance function and performance when compared to medical therapy or general exercises (Horak).
23. 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 64% (Shepard & Telian).