"We used to shift patients back between otolaryngology and neurology and we wanted to change that by emphasizing a coordinated balance center between the two departments."

Bruce Gantz, M.D.

Something was wrong with Kristin Reynolds. She could no longer walk her dog Josey because it made her dizzy. Picking up Luke and Jack, her twin two-year-old sons, caused her to experience blurred vision. Unloading the laundry made the room spin.

"I thought it was all tied to sinuses," said Reynolds, who has a history of allergies. "But then I was told to see a specialist."

Reynolds soon found that hers was a condition unrelated to sinus troubles.

Following a routine physical last January, she was sent to the Department of Otolaryngology--Ear, Nose, and Throat Clinic at University of Iowa Hospitals and Clinics, where she was immediately referred to Deema Fattal, M.D. in the Department of Neurology.

After performing several balance tests, including walking tests and an ENG (electronystagmography) that involved injecting water in Reynolds' ear, Fattal diagnosed Reynolds' condition as an asymmetry in her balance function. Reynolds' balance system on her right side was disrupted. As a result, she was experiencing vertigo. She also had recurring analgesic rebound headaches triggered by her frequent use of TylenolR, which she used to alleviate chronic migraines.

In another health care setting, Reynolds may not have had her condition diagnosed so quickly or, worse, not at all. Fattal is one of only a dozen neurologists in the United States who specialize in vertigo and other balance disorders.

Fattal represents a part of the team associated with one of UI Health Care's most unique clinics--the Balance Disorders Clinic.

The clinic officially started in July 2001 with the addition of Fattal, but the real origins came long before.

Nearly ten years ago, Bruce Gantz, M.D., head of otolaryngology, saw the need for a new clinic to specialize in treating people with vertigo and other balance disorders. Balance testing had been conducted by UI otolaryngologists for more than 30 years.

"Balance is a combination of inner ear, central, and eye function," said Gantz. "We wanted to differentiate diseases associated with the inner ear. We used to shift patients between otolaryngology and neurology, and we wanted to change that by emphasizing a coordinated balance center between the two departments."

Even with the idea in place, the wheels for the clinic were in slow motion. In order to successfully initiate the clinic, Gantz had to find a neurologist interested in treating balance disorders. After a long search, Gantz and Antonio Damasio, M.D., Ph.D., head of the Department of Neurology, eventually located the candidate they needed in Fattal.

Following a fellowship in behavioral neurology at UI Hospitals and Clinics, Fattal went to the University of Pittsburgh, where she was trained in balance disorders by Joseph Furman, M.D., a fellow neurologist who has nearly 20 years experience in diagnosing and treating patients with dizziness.

Once trained, Fattal completed the team Gantz had sought to form a decade earlier. Since then, she and Gantz have seen a steady flow of patients with dizziness.

"Right now, we have too many patients," said Gantz, noting the wait for some patients is two months. "We see four to six patients every day and it takes a long time to diagnose balance disorders."

Each patient undergoes an hour-long balance examination that includes tests of hearing, eye movements, and upright stability on something called a balance platform.

A big reason for the endless chain of patients is that the UI clinic is one of only a handful in the nation, even though dizziness in some form affects about one-fourth to one-third of the population.

"You have to have a lot of sub-specialty care and there is just not the interest out there," explained Gantz. "It is very expensive to put all the components together, but it's better care for the patient."

Reynolds can attest to that. "The multidisciplinary approach is excellent," she said. "It helped me get to the appropriate care provider right away."

It also helped Josey get a much-needed walk.

For more information, patients and families should call UI Health Access and ask for the Balance Disorders Clinic. Physicians seeking consultation or referral should call UI Consult.

Specialized treatment for vertigo and recurring analgesic rebound helped Kristin Reynolds regain the enjoyable times she spends walking her dog, Josie.