Dr. Gans Blog

Vestibular Rehabilitation Therapy (VRT) has long been recognized as the gold standard in the non-medical management of patients with chronic non-compensated vestibulopathy. The functional manifestations may be comprised of one or more of the following symptoms: Oscillopsia- blurred vision with active head movement at specific frequencies and direction. Vestibular recruitment- hypersensitivity, sense of exaggerated motion or after-motion at specific frequencies and direction of movement. Dependence on the vision and/or surface sensory modalities to maintain proper management of center of gravity Read More

According to the International Headache Society (IHC, 2014), pediatric migraine and specifically BPV of Childhood is classified as one of the six (6) categories of migraine. Most prevalent onset between the ages of one to five years of age. The episodes are characterized by brief attacks of incapacitating vertigo, often accompanied by nausea and emesis and postural imbalance. This condition is often a diagnosis of exclusion and there is no specific test to diagnose the condition. As migraine is best Read More

BPPV is among the most common causes of vertigo for children and adults. Canalith Repositioning Maneuvers (CRM) utilizing Epley, Gans or Semont methods or modifications have shown to be highly efficacious for all populations regardless of the specific protocol. In previous Gans Blogs we have shown treatment of BPPV for several adolescents with physical limitations secondary to Spina Bifida and Ostetogenesis Imperfecta.   The patient in this case study has a variety of physical considerations, which significantly reduced (she cannot Read More

By age 3-4 months, infant’s neck musculature is typically strong enough to provide sufficient support to allow for reliable use of cervical Vestibular Myogenic Potentials, (cVEMP). A question may be asked, why test a baby? The literature clearly shows the co-morbidities of sensorineural hearing loss (SNHL) and vestibular abnormalities. Therefore, it is our opinion and protocol at AIB, that all infants with identified SNHL should be screened with cVEMP. Their motor milestone development should also be closely monitored to reveal Read More

Head trauma with or without concussion is a well-known cause of BPPV in both children and adults. More importantly, BPPV secondary to head trauma has been associated with increased bilateral and multiple canal involvement as well as a higher recurrence rate. The benefit of the GRM and Semont Liberatory Maneuver (SLM) when treating bilateral cases, they use only 2 side-lying positions, so that the contralateral involved ear is not “triggered” or activated when the patient is placed in the second Read More