Talk:Benign paroxysmal positional vertigo

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[edit] Let's stay with what is helpful

This article is becoming very busy and disconnected.

I evaluate and treat BPPV patients daily. This article seems to focus more on rare associated symptoms instead of what is most common and most likely.

Let's stay with what is helpful and stay away from rare but possible symptoms. Let's keep this article helpful rather than confusing.

(Previously deleted comment originally posted on 05:36, 30 April 2006 by Edslee)

[edit] Deleting discussion/comments

1) I don't think is is appropriate to delete previous discussions about this topic.

I agree. I've restored the only deleted comment I could find in the edit history accordingly. (Vanessaezekowitz 00:19, 6 January 2007 (UTC))

[edit] New link

2) Someone added a new link (MedTerms). After reviewing the link, I think it is a poor description / definition of what BPPV is. My opinion is that it should be removed. Thoughts?

I agree. BPPV is not a "balance disorder."
True, it is a vestibular disorder. In any case, there are many more complete definitions of BPPV which are available to the public. I am not sure that the link adds anything to the page that is not already on the page. I think it should be removed also.
I removed it. - mab

[edit] Slurred Speech

Slurred Speech is not caused by BPPV. A rare few people may seem to have slurred speech due to the confusion and fear of the sudden onset of what may be frightening symptoms. However, there is no slurred speech. A stroke will cause slurred speech depending on the area of the brain that is affected. BPPV is a peripheral problem. It does not cause slurred speech. If you find slurred speech, you most likely got something else. Any other opinions? -edslee (04:58, 9 November 2006 Edslee)

edslee is correct - slurred speech is never associated with BPPV. Having it listed as a symptom is misleading and in fact dangerous, as slurred speech can be associated with stroke. I removed it. - mab

[edit] Crystals touching hairs inside canal

According to an ENT my husband consulted today for this very problem, the crystals can touch the hairs inside the canal and cause the symptoms to occur, in addition to that caused by the motion of the fluid. Vanessaezekowitz 00:19, 6 January 2007 (UTC)

That is almost correct. The "hair" you refer to (know as kinocilia) is in fact inside a small structure called a cupula. This can be likened to plastic wrap over the end of a large pipe. When fluid in the pipe moves it may buldge the plastic wrap causing the "hairs" inside the plastic wrap to bend which results in nerve energy being produced. The crystals seen in BPPV can either cuase the fluid to move (called canalolithasis) or actually sit on the palstic wrap itself (called cupulolithiasis). In this case the weight of the crystals causes the plastic wrap (cupula) to bend with gravity. This being said, only the first explanation (canalolithiasis) has been proven, the other (cupulolithiasis) is still a theory.- mab

[edit] Viral infection?

Can this problem be caused due to viral infection?206.195.19.46 18:08, 18 June 2007 (UTC)Ramya

My doctor believes so. I had a bout BPPV while feverish. It only lasted for a few hours, and had cleared up by morning. --Mdwyer 05:04, 19 June 2007 (UTC)

[edit] DizzyFix Reference

I don't think it should be in the body of the article. It is a commerical reference. I do agree that it is something that potentially can be very helpful to some patients. I suggest that it be moved to "external reference". Thoughts? -edslee

Wikipedia is not indented as a venue for commercials, however, so long as an idea is presented fairly and in a balanced perspective, as this appears to be, there is no reason to eliminate useful information from the body of articles. Imagine, if you eliminated references to "FORD" or "Microsoft" simply because they are companies. The Dizzyfix is presented as a home treatment device and balanced by the presentation of other hospital based devices. Both listed devices are treatments for BPPV and appear only in the treatment section. I therefore think it appropriate that they appear in the body of the article. I agree with edslee, care should be taken, but so long as commercial references are useful and fair they should be included in the body. -mab
Just to cite Wikipedia itself: "Advertising. Articles about companies and products are acceptable if they are written in an objective and unbiased style." I guess it can stay -JFB
Editor CliffC took exception to it at this edit and removed it. It was replaced by an annon editor during this edit. I think that CliffC's comment of "product promotion failing the spirit of WP:EL and the letter of WP:NOT" has merit, so I have re-removed the DizzyFix reference. I believe it probably DOES have a place, here, but an external link does NOT belong in the article body, and the whole text should be carefully considered so as not to be WP:SPAM. Right now, I consider it linkspam. --Mdwyer 00:36, 9 October 2007 (UTC)
The same anon IP came and reworked it in this edit. I still suspect a WP:COI on the editor's part, but I think the current handling of this takes care of my WP:SPAM and WP:EL concerns. Thank you, all, for your mature handling of this conflict. --Mdwyer 03:18, 31 October 2007 (UTC)

(resetting indentation) For what it's worth, one of the authors of the newly-cited paper mentioning DizzyFIX (abstract here at laryngoscope.com) has the same name as the CEO of Clearwater Clinical, manufacturers of DizzyFIX. I have not read the cited paper (it's pay-per-view) but based on the abstract, the DizzyFIX role seems secondary. The phrase "Using the DizzyFIX" is appended to the citation here in Wikipedia, but the cited paper is titled simply "Evaluation of a Particle Repositioning Maneuver Web-Based Teaching Module." The addition seems a bit of a stretch. --CliffC 04:28, 31 October 2007 (UTC)

[edit] Removed Link to Semont Maneuver Video

I recently had a link to a page hosting the video treatment of BPPV using the Semont maneuver deleted.

http://www.asktheneurologist.com/vertigo-cures.html

I believe that the video is highly relevant and authoritative as it has been peer-reviewed and linked to by the original article that I referenced (Radtke A, von Brevern M, Tiel-Wilck K, Mainz-Perchalla A, Neuhauser H, Lempert T. (2004). "Self-treatment of benign paroxysmal positional vertigo: Semont maneuver vs Epley procedure.". Neurology. 63(1).)

If anyone has a better way of linking to this video I would like to hear and add it that way.

with thanks

Sanjpatel1 (talk) 14:42, 20 November 2007 (UTC)

I am the editor who removed here the two recently added links to your site. Part of my reasoning was that I recall in the recent past removing links to the same site spammed across several articles. Also, adding a link at the very top of the external links section leaves the impression that the goal is simply to promote a web site. Wikipedia is not a free billboard, web directory, or catalog of medical devices. On the merits of the link as a reference, the site does not appear to pass Wikipedia:Notability guidelines. Notability means that something is important enough that the media has taken an interest in it, and has written about it, in more than one news article. Google shows few references to the site other than tenuous ones where the link was dropped into a blog. The site also fails WP:External links guidelines in that it requires registration to get further information.
The following is not directed at you, but more generally: Editors should ask themselves if they have a conflict of interest. A conflict of interest is when you create, or edit, an article about yourself, your family, company, product, or friends, as you would likely be unable to edit neutrally. Neutrality is one of the core policies of Wikipedia, as is verifiability. Verifiability means that any information given in an article must be verifiable with reliable, third-party sources. --CliffC (talk) 19:31, 21 November 2007 (UTC)

[edit] Journal Author

(from User talk:CliffC)

Cliffc - I see that you are busy on wikipedia. I am a physician who deals with bppv and am one of the authors of the recently published paper dealing with the treatment of BPPV. I am also a member of the company that now manufactures it. I object to the tone and implications in your recent post.

The device in question was developed with the support and supervision of our local university. This was 2-3 years ago. Since that time it has proved to work very well for a number of patients who have now apparently been posting it on Wikipedia, and had it removed by you, it seems. There are a number of other publications in press from research conducted over the past few years but this was the first to make it to print. As the local demand for the device grew it became necessary to find a way to make them in larger quantities - hence the formation of a company which has only now begun production.

There is always the question of conflict of interest when medical products move from research to market. However, the research referenced and the other pending publications have all been completed prior to the marketing of the device. While I cannot comment for those who have been debating/adding/moving the reference - in my opinion the device does provide a real medical benefit to those suffering from BPPV. As much as Epley should be referenced on the page I ask two things from you 1) Be careful what you imply as you may not have the whole story and 2) that you find some way or suggest some way that this device can be referenced on the page as the patients who have tried it seem to want to see on wikipedia. I have no interest in debating this but rather I reference "edslee" and "mdwyer" who suggest the external links tab.

Thank you for your dedicated policing of wikipedia. As I have in the past I will endeavor to continue submitting relevant and useful commentary on BPPV and other ENT topics. Mabromwich (talk) 20:14, 23 November 2007 (UTC)

I understand your desire to have the device mentioned in BPPV and other encyclopedia articles discussing vertigo, but "to find some way or suggest some way that this device can be referenced on the page as the patients who have tried it seem to want to see on wikipedia" is to put the cart before the horse. Once a person or place or product becomes notable, someone may wish to mention it in the encyclopedia, not the other way round. Once the product is mentioned by a Wikipedia:reliable source, someone can paraphrase or quote that source directly, perhaps something similar to "One method of treating BPPV at home that has shown some success is the DizzyFIX", followed by a <ref>...</ref> source citation.
I have spent considerable time reading about the DizzyFIX at the company web site and viewing the how-to video. The product is very interesting, in the most positive sense of that word, and seems promising. Having said the above regarding in-text mentions, if someone were to again add the external link I would not object.
Rambling here... you have likely thought of this already, but beyond sending out brochures to doctors, I wonder if getting a placement in AARP or some other geriatric magazine, or in the WebMD magazine I see in so many doctors' offices, would help get things kickstarted. (Would it need to say "prescription required in USA"? That might actually be a plus in today's ask-your-doctor advertising culture.) The product's unusual appearance would, I think, be an advertising plus. All the best, CliffC (talk) 16:58, 24 November 2007 (UTC)