Hello all. Well, my weekend was capped off right, with Spain
winning the EuroCup for the second consecutive time. Sunday morning
my pals and I met for breakfast, all in our Spain jerseys and began
getting ready for the final match that started later in the day. By
5 p.m., my buddies and I, along with anyone else in a red jersey,
were on cloud nine watching La Furia Roja raise the EuroCup once
again. This was the first time in history a national team has won 3
major titles in a row (EuroCup2010, World Cup 2010, EuroCup
2012).
I suppose that's enough gloating for now. Today I'd like to
share a little tale about a patient I began to see last week. This
patient had been seen before in our clinic about a year and a half
ago for the same complaint of dizziness. The patient had been
previously diagnosed and treated for cervicogenic vertigo. The
treatment given a year ago did help her condition, the patient
reported, but never really got rid of her dizzy spells. I say dizzy
spells, because what the patient described didn't sound like
vertigo. The patient was experiencing a sensation of falling
through the ground, almost as if she was riding a down-going
elevator. The spells could come at anytime during the day and were
reported to not have any correlation with head movement or any
other triggers. After working the patient up, my differential
diagnosis was leaning towards a cerebellar issue, possibly
cerebellar fatigue.
Dr. Humphreys
Neurological issues are somewhat difficult to nail down with a
definitive diagnosis and treatment. Realizing I may be a tad over
my head, I called in the big guns, Dr. Robert Humphreys,
neuro-extraordinaire. It just so happened that Dr. Humphreys was
here in Florida at the time, and took an hour out of his busy day
to help me and my patient, and perform a neuro evaluation. I can
now say from experience, that sitting through a lecture is one
thing, but actually watching Dr. H perform his exam and reason
through subtle cortical findings to reach a diagnosis, is something
completely different and extremely educational. Dr. H used
functional neurology to determine that the patient was experiencing
this symptom of falling due to a decreased ability of her left
cerebrum to communicate with her right cerebellum. Activating, or
jump-starting, the left side of her brain with propioceptive input
and known left-sided brain activities eliminated the patient's
secondary symptoms and previous positive cortical findings. It is
our hope, that with the treatment plan Dr. H and I came up with,
the patient's dizzy spells will also be eliminated.
I learned a lot from this patient. Aside of this being a cool
case, and getting to work with Dr. Humphreys, I think the real
lesson here was knowing when to ask for help. Yes, I could have
treated the patient how she was treated previously, she had
reported that the previous treatment had even helped, but would
that have been what was best for her? The patient's best interest
should always be at the forefront of treatment, not the doctor's
pride, or ease of a treatment regime. My patient appreciated me
telling her that I didn't know exactly what was wrong with her, but
I would find someone who could find out.
I hope everyone enjoyed the story today, and enjoys a nice break
in the middle of the week for Independence Day. I plan on spending
the day on the beach Wednesday doing what I do best.
Catch everyone on the flip side,
Dex