Dizzy Diagnostics

Dizzy Diagnostics Evidence-based resources for assessment and treatment of the vestibular system. NOT medical advice.
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All exercises should be performed under the supervision of a qualified clinician. We are Sara and Sydney, two physical therapists with a combined 20 years of experience working with patients with vestibular disorders. With a shared passion for vestibular rehab, we aim to equip fellow clinicians with evidence-based resources to provide high quality care to patients with vestibular disorders.

06/04/2026

Vestibular migraine is frequently missed, and as PTs and OTs, we are often the first to connect the dots for our patients. Here is how we approach it.

Screen for VM in your subjective. Ask about:
❓Personal history of migraine or motion sickness
❓Family history of migraine
❓Photophobia or phonophobia
❓Visual aura or other neurological symptoms

Assess for peripheral diagnoses that need to be ruled out: BPPV, vestibular neuritis / labyrinthitis, Ménière’s disease, etc.

Then educate. You don’t have to have all the answers, you just have to point your patient in the right direction.

Two resources we LOVE:

⬇️ Association of Migraine Disorders poster — a visual breakdown of migraine as a neurological disease, great to walk through with your patient

⬇️ VEDA’s vestibular migraine handout — clear, patient-friendly, and easy to send home

Comment ‘migraine’ and we will send you the links to these FREE resources!

Your patient has probably seen a lot of providers before they got to you. Be the one who finally gives them some direction and language for what they’re experiencing.

🧠 June is Migraine and Headache Awareness Month, and we’re using it to shine a light on one of the most underrecognized ...
06/04/2026

🧠 June is Migraine and Headache Awareness Month, and we’re using it to shine a light on one of the most underrecognized vestibular diagnoses out there: vestibular migraine (VM).

All month we’ll be breaking down everything clinicians need to know about VM, from how to spot it, to how to evaluate it, to how to treat it (and when not to).

Patients with VM often see multiple providers before getting the correct diagnosis. You might be the first person to finally point your patient in the right direction. Let’s make sure you know what to look for.

Follow along as we walk you through exactly what to do when you think your patient has VM.

05/26/2026

This is what a classic vestibular neuritis would look like!
✅ abnormal head impulse test
✅ direction fixed nystagmus
✅ normal test of skew

The patient in the video had a LEFT vestibular neuritis #

Here is an example of a case that would be more concerning:
‼️ normal head impulse test
‼️ direction changing nystagmus (right beat on right gaze, left beat on left gaze)
‼️ vertical eye deviation during test of skew

What questions do you have about the HINTS exam?

05/16/2026

What else do you try when the Epley doesn’t seem to be working?

One of the best ways to start to differentiate between these conditions is to get a really thorough subjective history.H...
05/12/2026

One of the best ways to start to differentiate between these conditions is to get a really thorough subjective history.

Here are some questions to prompt a good history taking:

What does it feel like?
Is it constant or intermittent?
How long does it last (if intermittent)?
Are there things that trigger it?
Are there things that make it better?
Do you have a history of vertigo?
Do you have any other associated symptoms?
Ear fullness or pain? Hearing loss? Tinnitus?
Headache? Light or sound sensitivity?
Any history of migraine (personal or family) or motion sickness?

05/01/2026

Sleep is one of the most overlooked drivers of dizziness.

Here are the questions we’re routinely asking vestibular patients:

💤 How many hours of sleep are you getting each night?
💤 Do you fall asleep easily?
💤 How often are you waking up during the night?
💤 Do you feel rested when you wake up?
💤 Do your symptoms feel worse after a poor night of sleep?

Dig a little deeper when needed:

🛌 Any history of sleep apnea?
🛌 Have you had a sleep study?
🛌 If you have a CPAP, are you using it consistently?
🛌 Do you snore?
☕️ What’s your caffeine timing and intake?
📱 Are you scrolling or on screens right before bed?

It can be helpful to provide some general sleep hygiene tips, but make sure to refer out if sleep apnea is suspected.

04/30/2026

A little bit of a rant, but mostly posting this to advocate for better care for vestibular patients!!!

Has anyone heard similar stories?

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Baton Rouge, LA

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https://linktr.ee/dizzydiagnostics

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