Blog Category: Dr. Gans Blog

Video-Case Study Pediatric Migraine – Benign Paroxysmal Vertigo of Childhood/Infancy

VIDEO CASE STUDY: Biomechanics of Gans Repositioning Maneuver (GRM) for a Little Person with bilateral PC-BPPV
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

VIDEO CASE STUDY: Biomechanics of Gans Repositioning Maneuver (GRM) for a Little Person with bilateral PC-BPPV

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

VIDEO CASE STUDY: cVEMP- Best Test for Infants

VIDEO CASE STUDY: cVEMP- Best Test for Infants
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

VIDEO – CASE STUDY: Gans Repositioning Maneuver (GRM): Treatment of Bilateral PC-BPPV Post Head Trauma

VIDEO - CASE STUDY: Gans Repositioning Maneuver (GRM): Treatment of Bilateral PC-BPPV Post Head Trauma
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

VIDEO: CASE STUDY – Treatment of sub-clinical HC-BPPV in a 15 year-old male post basilar skull fracture and concussion

VIDEO: CASE STUDY - Treatment of sub-clinical HC-BPPV in a 15 year-old male post basilar skull fracture and concussion
The literature and this author has presented extensively on the incidence of BPPV post head trauma in children and adults, with and without concussion. Trauma induced BPPV tends to be more bilateral and it is not unusual to involve multiple canals. Often times, because the severity of the head trauma is considerable, BPPV may be overlooked as the simplest genesis of a patient’s chronic dizziness. Although diagnosis of BPPV considers both the presence of a transient and paired nystagmus (type Read More