NEWS & REVIEWS By Susan L. Engel-Arieli, M.D. Below are summaries of articles that appeared in recent medical journals. CHRONIC DIZZINESS: DIAGNOSIS, & TREATMENT Dr. M. Hamid states that dizziness is one of the top four symptoms for which patients go to a doctor. He says that the key to good treatment is good diagnosis and that a detailed history is essential to making a diagnosis. Questions that he believes are important to ask patients are: Do you experience a sense of rotation (usually associated with inner ear disorders)? When did the dizziness start? What brings it on? How severe is it? How long does it last? Are there other symptoms (such as hearing loss, tinnitus, pressure, headaches, seizures, weakness)? Do you smoke, take prescription or other drugs, drink, or take illicit drugs? A presence and pattern of abnormal nystagmus (eye movements) can help provide further information that may determine a diagnosis. In vestibular vertigo, Dr. Hamid says, the eyes often drift to the affected side and then return to the center, and the nystagmus can be suppressed with the eyes open. In central (brain-related) vertigo, the nystagmus can be in both eyes, is often vertical, and is often increased with visual fixation. If nystagmus does not initially show up, the doctor can often detect it by palpating the patient's closed eyelids, asking the patient to shake his or her head while reading, or by using special glasses called Frenzel glasses. Treatment depends on the diagnosis. Dr. Hamid states that positional dizziness is treated with home-based vestibular exercises and, in some cases, medications. BPPV (benign paroxysmal positional vertigo) is treated with the Semont maneuver or Cawthorne exercises. Meniere's disease is often treated with salt restriction, water pills, labyrinthine sedatives, or surgery in incapacitating cases. Vestibular neuronitis is also treated with medications and rehabilitation. Brain- related dizziness is more difficult to treat; the choice of treatment depends on the specific cause. See Hamid, M., "Chronic Dizziness: Vestibular Evaluation and Rehabilitation," Cleveland Clinics Journal of Medicine, July-August 1994, pages 247-249. BENIGN PAROXYSMAL POSITIONAL NYSTAGMUS (BPPV) BPPV is a syndrome of recurring vertigo, nystagmus, and nausea that is usually triggered by certain head positions. The nystagmus is often vertical and rotatory. (You can't see this in yourself.) The exact causes are not known, but Dr. Ronald Tusa, of the University of Miami Ear Institute, says that there are two hypotheses. One, the cupulolithiasis theory, says that debris sticks to the cupula of a semicircular ear canal. The other, the canalithiasis theory, holds that debris floats into one of the semicircular canals and disturbs its cupula. Dr. Tusa reviews three basic treatments: the Brandt-Daroff exercises; the Semont maneuver, which assumes cupulolithiasis as the cause, and the Epley maneuver, designed to correct canalithiasis. The Brandt-Daroff exercises must be performed many times a day or daily, whereas the Semont and Epley maneuvers involve only a single 10-15 minute session in a physician's office. After one treatment with the Semont maneuver, 70 percent of 30 patients became symptom-free; 20 percent reported at least a 70 percent improvement, and 10 percent had less than 70 percent improvement. The Epley maneuver (one treatment) provided complete relief in 57 percent of 30 patients; 33 percent improved by at least 70 percent, and 10 percent improved less than 70 percent. Both the Semont and Epley maneuvers were found to be effective. If one maneuver fails to completely relieve the symptoms, the other can be tried, or the same maneuver can be repeated. Patients usually become initially more dizzy during the maneuvers, are placed in a cervical collar, told to avoid bending, and advised to sleep only in a sitting position during the 48 hours after treatment. See "Treating Benign Positional Vertigo in the Office," Emergency Medicine, Feb. 15, 1994, pages 96-102. MORE ON DIZZINESS Dr. Kurt Kroenke, Bethesda, Maryland, recently wrote a general review article on dizziness. He stated that 90 percent of vertigo episodes resulted from a peripheral (usually ear-related) cause. These episodes are usually either BPPV, vestibular neuronitis or labyrinthitis, or Meniere's disease. When dizziness occurs before a feeling of faintness, Dr. Kroenke said, it is usually not caused by a serious problem with heart rhythm (although this must be confirmed) but is more commonly caused by medications or blood pressure problems. Equilibrium problems are often observed in elderly people with prior strokes, nerve problems, arthritis, or Parkinson's disease. Dr. Kroenke goes on to state that one- third of the people with initial dizziness will recover in two weeks, and more than 50 percent will improve in the next 12 months. Dizziness seldom represents a life-threatening disorder. In one study, only 1 of 100 patients with a chief complaint of dizziness died within 12 months, and this death was unrelated to dizziness. People with chronic vestibular problems usually have the disease in only one ear, and the dizziness may slowly abate as the opposite ear compensates. Some people with chronic dizziness adjust to their disorder and develop coping mechanisms, just like people with other chronic disorders. See Kroenke, Kurt, "9 Questions on Evaluating the Dizzy Patient," Hudson Monitor, January 1994, pages 43-46. HEAD TRAUMA CAN CAUSE A PERILYMPH FISTULA Vertigo or balance problems can occur in people after head trauma (not necessarily with loss of consciousness) and may produce a perilymph fistula from the inner ear through the middle ear. With time, the fistula can heal on its own. If it does not heal, or if there is hearing loss, surgery may be necessary; a fistula is highly curable. See Lehrer, Joel, et al., "Perilymphatic Fistula - A Definitive and Curable Cause of Vertigo Following Head Trauma," Western Journal of Medicine, Vol. 141, No. 1, July 19, 1984, pages 57-60. [Author's note: This article was kindly submitted to me by Dr. Lehrer to emphasize that perilymph fistulas can be treated with surgery when appropriate and necessary.] A VARIANT OF BPPV Dr. Robert Baloh and his colleagues reported in a recent article that 13 patients had a previously unrecognized, direction- changing, horizontal, positional nystagmus. Normally BPPV is linked to a torsional, vertical nystagmus that fatigues with repeated positioning. Dr. Baloh, et al., believe that this new syndrome is a variant of BPPV and represents debris in one of the horizontal canals of the inner ear. Positional exercises and maneuvers have not, so far, been found to significantly help the symptoms of this variant of BPPV. See Baloh, R., Jacobson, K., and Honrubia, V., "Horizontal Semicircular Canal Variant of Benign Positional Vertigo," Neurology, Vol. 43, Dec. 1993, pages 2542-2549. ACOUSTIC NEUROMAS Acoustic neuromas are benign tumors that arise in the vestibular nerve; about 2,000 to 3,000 new cases occur in the U.S. each year. The most common initial symptoms are one-sided hearing loss (93 percent), tinnitus (61 percent), and imbalance (36 percent). If this tumor is found, the treatment is dependent on the size of the tumor, the hearing loss, and the age and health of the patient. Generally surgery is recommended; techniques are used to try to prevent further hearing loss. See Leonetti, J.P., "The Diagnosis and Management of Acoustic Neuromas," Chicago Medicine, April 21, 1994, pages 27-32. Below are summaries of articles appearing in recent consumer publications: DO YOU FEEL DIZZY? If you're on a ship's deck, you can avoid seasickness by training your eyes to look out on the horizon; this way your eyes, inner ears, and legs tell your brain that you're swaying. However, once you go below the deck, you can become very sick because your brain is receiving conflicting sensory information. According to an article in American Health, most people with seasickness quickly recover when they're on solid ground. However, people with balance disorders can have continuing problems for months or years. The human balance system is usually adaptable, as professional skaters who do multiple spins know very well. If a skater stays off the ice for a few weeks, the first time the skater spins, he or she will be nauseated and may even throw up. Skaters must spin over and over to suppress the tremendous sensation of vertigo. The article also describes some of the pros and cons of surgery and suggests that surgery be chosen only if other treatments have not worked. In some cases, patients may be incorrectly diagnosed with a disorder for which surgery may be helpful, but in reality they may have a disorder that is best helped by exercises, maneuvers, or medications. The article also briefly mentions VEDA. See Conway, Claire, "Do You Feel Dizzy?" American Health, Dec. 1993, pages 64-67. WHAT'S MAKING YOU DIZZY? Every year more than 5 million people go to doctors with complaints of dizziness. An article in Your Health states that some of the most common causes include BPPV, Meniere's disease, and seasickness. The article describes posturography tests, which can evaluate the components of balance, such as the inner ears, eyes, muscles, and joints. See "What's Making You Dizzy?" Your Health, March 8, 1994, page 53. DIZZY WITH CONCENTRATION PROBLEMS? A recent Family Circle article discusses some basic ear anatomy as it relates to vertigo and reviews some common causes. Two of VEDA's medical and scientific advisors, Cherri Roskie, R.N., of Portland, Oregon, and Neil T. Shepard, Ph.D., of Ann Arbor, Michigan, are quoted, as are several other experts and patients. VEDA is named as a source of information. The article also discusses vestibular rehabilitation exercises; it says that about 80 percent of patients with vertigo related to a vestibular disorder have significant improvement with these exercises and that one-third recover completely. See Eberlein, Tamara, "Tired? Dizzy? Can't Concentrate?" Family Circle, pages 160-162. SILENCING THE NOISES An article in Health starts out with the thought that all tinnitus patients would love to "suffer in silence." Hearing specialists at the Oregon Health Sciences University in Portland, Oregon, have found that the drug Xanax can effectively help tinnitus. This discovery may be useful to some of the one American in every six who suffer from tinnitus. Although not a cure, the drug was found to reduce suffering from tinnitus by 40 percent or more in three- quarters of the patients tested. However, the drug has risks and can be habit- forming. See "At Last, a Silence Pill," Health, Nov./Dec. 1993, pages 30-32. NEWS BRIEFS IN THE NEWS Gail Steslow, a VEDA member and support group leader, was featured recently in an article in the Schenectady (New York) Daily Gazette. The article focused on Ms. Steslow's experiences with Meniere's disease since 1980, when her symptoms began. Her treatments have included shunt surgery as well as inner ear perfusion with streptomycin and, later, gentamicin. Though the disease has put new limits on her life, she enjoys gardening, the article said. At the urging of her minister, she started a support group three years ago, and the group meets monthly at her home. "What we find with Meniere's is that what helps one person doesn't always help another," she told the Gazette. Ms. Steslow said the article "generated quite a few calls. I've also had people stop me in stores and talk to me. They all seem so happy to have someone to talk to, for even just a few minutes, who understands what they are going through." YOUR BODY FROM HAIR TO HEEL Curious about how the brain works? Wonder what goes on in your liver? Susan L. Engel-Arieli, M.D., has written a book to explain these things and much more. How Your Body Works is an easy-to-read, lavishly illustrated overview of such things as how your ticker ticks, how your skin protects you, how your lungs filter air, and what's behind allergies, diabetes, and cancer, and many other disorders. Chapter 3, on the ear, includes information about the vestibular system and balance disorders. Published by Ziff-Davis Press as part of its "How It Works" series, the 175-page paperback can be found in the health/reference sections of bookstores across the U.S. as well as in Canada and the United Kingdom. The price in the U.S. is $19.95. Dr. Engel-Arieli received her medical degree from the University of Health Sciences/The Chicago Medical School and has been active as a writer, consultant, and medical director of pharmaceutical research. She is a former member of the VEDA board of directors and writes "News and Reviews" for On the Level. FOLIO SUBMISSIONS "Vestibular Folio," which appears on pages 10 and 11, needs material from VEDA members. Please send your original writings, drawings, or other creative expressions to "Vestibular Folio" in care of VEDA for coming editions. Those expressions may include creative photographs. You may also use photography as a medium to show work such as sculpture or fabric art. Photos should be high-quality, black-and-white prints, not color prints, not slides, not negatives, not Polaroids. We can re-size photos to fit. Texts should be kept short. A support group is being formed in Orange County, Calif. It's a satellite of the balance disorders support group at UCLA and is under the auspices of the Victor Goodhill Ear Center, Division of Head and Neck Surgery, UCLA School of Medicine through a grant from the National Institutes of Deafness and Other Communication Disorders. Meetings will include educational presentations and self-help sessions. For more information or to be put on the mailing list, call Marjorie Harris at (310) 825-5131. A T'ai Chi instructor spoke to the Sacramento, Calif., group in October. Her topic was "T'ai Chi: Meniere's Meets Chinese Meditative Exercise Aid." The group planned an informal discussion for November. A medical news reporter interviewed members of the St. Louis, Mo., group in September. He was working on a TV news story on assistive listening devices. In October, a guest speaker addressed the group on "The Spiritual Aspects of Suffering." During its first year, the membership of Redwood City, Calif., group has grown from 3 to 100, according to the September 1994 edition of the group's newsletter, In Balance. Group members held a potluck in September to discuss structural problems related to the rapid growth. Guest speakers at recent meetings of the Nashville, Tenn., group included an audiologist and a social worker. The August issue of the group's newsletter featured an article on how meditation may help people with vestibular disorders. Guest speakers this fall at meetings of the Royal Oak, Mich., group included an audiologist, a neuro-otologist, and the director of a balance lab. 5,000 MEMBERS VEDA membership rose to a new high on Sept. 20. Martha Hensal, from Norton, Ohio, whose membership pushed the total to 5,000, was awarded a free VEDA T-shirt in honor of the occasion. NOMINATIONS Nominations for seats on the 1995-97 VEDA board of directors will be accepted in January and February. If you or someone you admire would like to run for election to the VEDA board for a two-year term starting in June 1995, please write to VEDA or call us and request a nomination form or forms. HANK YOU We thank all of the following for their contributions to VEDA through Sept. 28, 1994: Associates ($100 to $499): Martin Gizzi M.D., Ph.D., New Jersey; Lawrence Mayer, New Jersey; Mr. & Mrs. Domenick Celentano, New Jersey; Kathryn & John Nudo, Illinois; Kurt Pfaff, Virginia; Fred Burnstead, Washington; John Routh Jr., Connecticut; Eva Dimitrov M.D., Florida; Ruth Abbett, New York; Donald P. Tormey D.D.S., California; Shirley Zahrn, South Carolina; Helen MacDonald, Iowa; Richard Krause, Oregon; Edwin Gale, Texas; North Broward Neurological Institute, Florida; Isaac Frishman, Maryland; Mary Thomason, Idaho; Naomi Lederer, New York; Edwin Gale, Texas; Carl Lund, Illinois; Harold Feld, New York; Edwin Martin, Florida; Carol Dunlap, Maryland; Michael D. Kaplan, New York. Contributors ($10 to $99): ALABAMA: Lisa Santer, Helen Kreisch, Larry Sampson, Mary Folmar, Lewis Ellenburg, Frances Frost, Judy Nation, Helen Dykes. ALASKA: Barbara Kolberg, Eleanor Tyler, Karil Ann Miller, Nancy Stivers, Patience Campbell. ARIZONA: Mildred Kennedy, Mary Ann Zitta, Joan Hafter, Jerry Eastridge, Norma Raya, Marjorie Rolfe, Diana Kruglick. ARKANSAS: Gina Skelton, Ralph Palmer, Nancy Summers, Billie Reynolds, William Owings. CALIFORNIA: Karolyn Zebarth, Vicki Reeder, Charles Stockley, Elizabeth Harris, Mary B. Miller, Michael Locke, Alice Werbel, Coleman Posard, Mary Chandler, Iris Braschuk, Phyllis Halladay, Dorothea Bechtelheimer, Peter Mackerness, Kathryn Dermant, Derrick Nylander, Lois Ramos, Rachel Frese, Monique Harriton, Vincent Gelezunas, Ingrid Ebstein, Mildred Featherstone, Priscilla Krinsky, Eleanor Fletcher, Janet Mooers, Andrew Mirisch, Dr. & Mrs. Robert Logan, Stephen Glucoft, Mrs. Winifred McLaughlin, Mr. & Mrs. Robert Sachs, James Sandweiss, Beth Sibley, Jacqueline Cursi, C.J. Ziady, Shane Gregory, Ann Ward, Mrs. Geraldine White, Myron Roth, Sue Krebs, Fred Meinzen, Fred Weiner D.D.S., Elizabeth Larsen, Larry Krause, John Pino, Diane Graybehl, Johanna Carmassi, Margaret Middleton, Martha De Barros, Vivian Gatzert, Glen Kailey, Larry Strom, Michael Ross, John Fitzgerald, Margery Derrick, Ann Ulrich, Marjorie Gentner, Irving Abrams, Barbara Shumaker, Arturita Tolentino, Douglas Atkins, Edward Guill, Josephine Tarver, Eugenia Culbertson, Sylvia Strum, Gene Anderson, Mary Bushnell, Marguerite Brinegar, Mary B. Miller, Meniere's Support Group of Sacramento, James Dale, Nancy Bischoff, Helen Hansen, Nessie Strudley, Deem Rahall, Reta Tyree, Darrell O'Briant, Carol Yeager, Patricia Schlabes, Eva G. Neel, Sonia Kirk, Dr. A.D. Adins, Irene Althaus, Fred Austin, Joan Kraus. COLORADO: Phyllis Pappu, Claude Selitrennikoff, Thomas Bohlinger, Bernard Shahan, Janice Gilland, Kim Johnston, Lois Jensen, Verla Jamison, Paul & Myrna Sunberg, Martha Nye. CONNECTICUT: M. Roccapriore, Frank McDonnell, Ruth Tryon, Pam Langer, Beatrice Horowitz, Bill Murphy, Alan Vogel, Lisa Knapp, Harry Whipple, Barbara & Hal Levine, Anne Altern, Harold Friedman, Denise Kateley, John Kveton M.D., Gerald Labriola M.D., Pamela Post, Yasmine Cronin, Donald Valerie Sr., Mrs. Richard Reilly, Rena Miller, William Petit Jr. M.D., Ruth Watt, Mary Dargan. DELAWARE: Bernardine Lunski, Doris Welch, Phyllis Lord. DISTRICT OF COLUMBIA: Albert Francis Jr. FLORIDA: Joyce Demers, Madeline Hendon, Jack Rubenstein, Jennifer Low, Marian Kline, Gladys Brancaccio, Gerda Wassermann, Henry Getzoff, Mary King, H.A. Poulin, Lucille Anderson, Ron & Barbara Elkman, John Viking, Anita Feagles, Barbara Drew, Tess Cole, Donna Clark, Daryl Chapin, Nancy Nussbaum, C. Joel Veal Jr., Norman Ahlswede, Dorothy Robinson, Norman & Eunice Foote, Pamela Lipofsky, Julianne Bennett, Alfonso Vaccarello, Charles McCain, Carlton Jones, Elmer Swanson, Hannah Polansky, Mary Jo Murray, Louise Essrig, Patricia Kennedy, Peg Kunz, Lillian Hillman, Bethany Wansor, Jessie Markham, Alden Gordon Finley, Florence Lillicrapp, Diane Shell, Catherine Nixon. GEORGIA: Patti Hallowell, Barbara Gatens CCC-A, Richardine Freeman, William Laney, Katherine Gaines, Mary Castiglioni, Reba Smithline, Francess Wilson, Sarah Rondeau, Annette Hatcher, Donald Loudermilk, Louise Williams, Gilbert Taylor, James McCloskey. IDAHO: L.S. Rambo, Patricia Roberts. ILLINOIS: Chester Moculeski, Frances Kierczynski, Ruth Fullerton, Thomas Casey, Gertrude Zaransky, Ron Wielage, Frances Randall, Elsie Ryan, Rita Eckhart, J. Craig Dutton, Arlene Stielow, Henrietta Schuhart, Adrienne Cosenza, Kathryn Jackson, Marilyn Beck, Pauline Clancy, Sr. Ann Gill, Darleen Runge, Margaret Berzin, Ted Graham, Anne Wight, Mildred Walter, Ida Kulach, Donna Novack, Mary Querio, Micromedical Technologies, John Blankenburg, Mary Ellen Bell, Charles Chopard, Mary Quade, Richard Wasser, Catherine Beckner, William Goebel, Mary Jadrich, W.T. Peterson, Donna Adams, Mary Speiden. INDIANA: Joanne Jones, Curtis Nold, James Young, Jayne Meth, G.K. Bhagavan, Linda Newman. IOWA: Mildred Cox, Kathryn Coyle, Kathleen Lensch, Virginia Ryan, Howard Morris, Jill Avery. KANSAS: Reva Frazee, Thomas Shutt, Paul White, John Webb, John Peterson, John Voss, Betty Gearhart, Beverly Womochil. KENTUCKY: Shirley Hallmark, June Roberts, Edylou Glenn. LOUISIANA: Annemarie Maher, Audrick Juneau, Kathy Chauvin. MAINE: Allene White, Bethel Arbuckle, Jean Robillard. MARYLAND: Laura Russ, Brenda Hall, Celia Weinstein, Ermene Lilly, Mary Zamary R.N., Marge Attenburger, Stanley Oliver, Earl Lindveit, Louisa Magzanian, Cornelia Ives, Lavern Riggs, Jaclyn Portnoy. MASSACHUSETTS: Digital Equipment Corporation, Marilyn De Filippis, Frances Clohecy, Joan Chaplick, Natalie Tompkins, Patricia Bates, Kathy Longo, Mary Lelievre, Mary Slack, Mary Kendrick, Rev. James Malley S.J., Edward Horton, Vicky Slavin, Angela Crofford-Bik, Eunice Good, Bruno Carmen, Theresa Robbins, Martha Plotkin, Elizabeth Ford, Marion Coughlin, Jean Miller, Mr. & Mrs. Rick Rowan, Susan Bayard, Walter Kovaleski, Ann Drew, Jacob Lichman, Irma Aponte, Anne & John Kendrick, Bernice Hicks, Rose Mandill, Pat Papagui, Gretchen Dunoyer, Wendy Marshall, Barbara Pasquale, Susie Jenkins, Natalie Tompkins, Darrell Daybre, Kay Hurley, Beulah Morrison, Michael Impastato, Philip Levin. MICHIGAN: Sara Essex, Carolyn Bush, June Evans, Paul Olson, Laurie Racey, Steven Eisenberg, Carole Reynolds, Joseph Bulone, Dennis Bojrab M.D., June Gravitt, Roger Roley, Patricia LaCasse, Patricia Klein, Marie Key, Judi Ellis, Katherine Kerr, Rebecca Szabo, Jack Wunderlich, Doreen Wise-Friedenberg. MINNESOTA: Patricia Jensen, Peter Rech, Linda Fort, Frank Moon, Charles A. Bobertz, Stella Fritsch, Angela Kaiser, Walter Voss, Mary Spinler, Endelena Goeb. MISSISSIPPI: B. Frank Vogel M.D.; Edith Welch, Clifford Comfort. MISSOURI: Frances Lewis, J. Edward Kendrick D.D.S., Kathy Black, Olive Duffy, Angela Comstock. MONTANA: James Hauwiller, Donna Sims, Sherry Marsillo, Bette Albright, Jennifer Laing. NEBRASKA: Duane Wolske, Jack Silk. NEVADA: John Perkowski, Dagmar Loe, Pauline Berliner. NEW HAMPSHIRE: Joi Undiano, Louise Richard, Rose Matarazzo, Ruth Edwards. NEW JERSEY: Jill Spasser, Teresa Smyth, Kenneth Davis, Alexander Hochheiser D.M.D., Carol Vandegrift, Rita Price, Dr. Marc Picchierri, Lisa Wagner, Barbara Bevel, Mary Pomanowski, Beatrice Zimmerman, David Hildreth, Kenneth Marks, Michele Degan, Patrice McDermott, Albert Wolfe, Katharine McGuire, Mr. & Mrs. Philip Kaufman, Beulah Cruikshank, Dawn Fabricatore, Henry Mikulewicz, Frank Dolcemascolo, Rosa Gavasci, Sandra Fearns, Julio Gonzalvez, Gladys Paul, Janet Kwiatkoski, Emma Trombley, Marlene Massrie, Harry Bott, Kathy Feichtl, Ellen Cohen, Viola Ferris, Charlene Streko, Frank Spinella, Adele Miller, Joann Bruno, Gail Flynn, Anne Condon, Roxana Melnitschenko, Dorothy Lorch, Christopher Kane, Palma Davison. NEW MEXICO: Wendy Babcock PT, Timothy Dippold, Frances Storey, Barbara Bailey, Kit Hagen Stein. NEW YORK: Joan Tarr, Mary Allegra, George Mahoney, Beatrice Wolfus, Shirley Weiss, Doreit Bialer, Lydia Chang, Linda McKenna, Joseph Haydayz, John Thos & Catherine Grubel, Serkiz Esmez, Sara Lucks, Dorothy Rabkin, Gay Kinzer, Rita Demers, Doris Engel, Marcella Schifrin, Sara & Abraham Reback, Beverly Rauch, Fanny Acuna, Andrea Butje, Arthur Golann, Leslie Zamft, Jill Short, Murray Blander, Ronald Jablonski, Kathleen Burgess, Joseph Giuliano, Dorisann Rinaldo R.N., Daniel Caccavo, Toni Sergi, H. Peter Allen, Abreena Tlumak, Dorothy Launer, Hilda Delson, Patricia Breglio, Mary McCarthy, Jeffrey Fuchs, Donald Witt, Ernest Puce, Baltfriet Verderber, Henry Hoecker, Roscha Folger, Naomi Utevsky, Alene Gurin, Layle Silbert, Mary Dornheim, Rosalie Fanning, Gordon Magill M.D., Kenneth Davis Jr., Ernest Caruso, Dana Oviatt, Muriel Opell, Barbara LaVenture, Gerald Levine, Dagoberto Molerio, Glen Cuccinello, Caroline Baldo Hawk, Margaret Arena, Virginia Bersohn, Donald Gregg, Paul Heide, Sylvia Edelstein, Zelda Heffer, Raymond McGowan, Irene Arndt, Patricia Kross, Phyllis Marcus, Magnus Bassey, Lewis French, Betty Stott, Stella Auricchio, Robert Marsin, Sylvia Heim, John DiBiase, Peter Maglaras, Leonard Bemel, John Kelleher, Mary Torrales, Mary Whitworth, Concetta Kudirka, Mildred Blank, George Holzmann, Mary Allegra, Mary Corrado, C.A. Sutton, Malinda Myers, Monte Florman, Roseann Crabb, Carola Michael, P.E. Hammerschlag M.D., Grace Jackson, Mimi Radin, Mary Dowd, Sydel Chernoff, Catherine Nicolas, Ruth Strasenburgh, Jane Schlick, Carol Venanzi, Jerome Court, Istvan Deak, David Hirsch, Louis Chiavetta, Nancy Doyle, Armando Girillo, Mary Braverman, Marjorie Goldstene, Barbara Strongin, Janis Rosenbaum, Dian Yanessa, Carol Sefcik. NORTH CAROLINA: C. Joan Adams, Lisa Jacobs, Anne Freeze, Mary Aselin, Elizabeth Keating, Susan Clayton Anderson, Harriet Hinson, Jesse Barnes, William Smith Jr., Robert Kirkpatrick, Dorothy Allen, Dianne Kolb. NORTH DAKOTA: Vicki Martinson, Avis Busse, Esther Kysar. OHIO: Eileen Annest, John Brush, Roseann Stube, Lisa Billings, Samuel Varghese M.D., Matilda Courey, Laura Craven, Chris Wasson, Toni Gendler, Monica Kandrac, Marie Christopher, Carol Leslie, Joseph Paton, Frances Marteney, Janet Kadunc, June Adams, Elizabeth Rayner, Willis Wolf, Helen Engdahl, Dan Hamilton, Irwin Ungar, Thornton Lake, Ann Graham, Elaine & Robert Stein, Reta Bisesi, Dorothy Rice, Wilfred Schroeder, Evelyn Newbauer. OKLAHOMA: Mildred Hughes, Leann Foraker, Anne Carmack, Horace Calvert. OREGON: Charlotte Shupert, Ann Mackintosh, Annelia Knutson, Elizabeth Shane, Louise Pollard, Rick Braithwaite, Wendell Cook, Bette Richards, Sandra Merrick, Ida Barbeau, Richard Syring, Dorothea Radel, R. Ken Ellison, Tom Hashizume, Wilfred & Verna Willer, Etta Brown, Eugene Kirby, Lisa Haven, Darlene Griser, Marion Byron, Virginia Gushwa, Alice Tvetan, M. Norine Wagner, Robert Stokes, Sylvia McKeehan, Maurice McCann, Lois Weathers, Carol Sams, Idella Allen, Nancy Gibbons, Debra Connors, PENNSYLVANIA: Deborah Simon, Paul Moretti, Mario Dentino, Harley Foelker, Joan Strobel, Jeff Zimmerman, Linda Dunmire, Leonid Kotlyar, Alverta Wenrick, Julie Nieminski, Fredric Pement, Irwin Gross, Mary Caruso, Dorothy Yarnell, Michael Kichi, Gertrude Oschwald, Katherine Zollars, Susan Cox, Donna Arnold, Michaelene Ross, Adriana Salini, Jacqueline Brookman, Bridget Quinn, Hilda Fleiner, Don Leisey, National Organization for Hearing Research, Doris Africa. RHODE ISLAND: Jane Hall, Edward Carosi, Armand Ferland. SOUTH DAKOTA: Dolores Shanks. TENNESSEE: F.M. Kofmehl, Janet Clark, Debbie Pigna, Meredith Leslie, James Littrell Jr. TEXAS: Mary Engler, Helen Barr, Susan Paul, Jane Durbin, Esther Seiler, L.J. Keating, Carter Beghtol, George Parker, Gale Robertson, Barbara Case, Jean Banks, Vivien Buckner, Jim Maxwell, Loyd Powell Jr., Susan Hendricson, Marion Worsham, Susan Frensley, Bessie Pitt, Susan Krus, David F. Cason, Shirley McIntyre, Patsy Faubion. UTAH: Jennifer Thurston. VERMONT: Edward McGarghan. VIRGINIA: Kaye Shubert, Kathryn Spatz, Virginia Rader, Richard Queisser, Carrington Dunlap, Carl Freeman, Margaret Douglas, J. Lynn Cornwell Jr., Linda J. Allen, Robert Golden, Cynthia Hartwell, Patricia Wexelblat, Barbara Haughwout, Debbie Noble, Abdul Ghafoor, Rebecca Stone, Louis Mauro, Joanne Zins, Lucie Moorman, Ann Humphries, Dwight Waldo, Margaret Riley, Mary Melegari, Tony Levinson, Benjamin Brockenbaugh, Peggy Putt Barton, J.C. Haskins, Margaret Paul, June Battaile, Lauren Berger, Jacklyn Fleenor. WASHINGTON: Mercedes Swanson, John & Sue Parks, Barbara Thompson, Phillip Friend, Robert McFarland, Jill Smith, Art Edburg, Sharon Covey, Betty Donnerberg, Robert Jones, Steve Rees, Traci Lamb-Kwon, Sara Pease, Alma Ellefson, Ed Johnson, Louise Downs, Burma Williams, Betty Novak, Eleanore McGee, Melanie Humfleet, Veronica Buffington, Alfred Muller, Richard Lundquist, Christine Martin, William Kubicz Jr., Edmund Parker, T. Roger Billeter, Foster Bucher. WEST VIRGINIA: George Bennett, Dr. Ruth Gross. WISCONSIN: John Heighway M.D., Ray Rosenmerkel, Russell Oldenburg, Shirley Ruediger, Sandra Carlson, Doris Wyatt, Martha Recknagel, Dianne Gray, Orville Hoffman, Steven Millen M.D., Sandra Carlson. WYOMING: Raymond DeVries Sr. AUSTRALIA: Ester Copley. CANADA: Anne Marie McDonald, Marcia Theriault, David Cameron, Rosemary Derbecker, Ruth Roth, Edith Gregory, Riva Guttman, Giovanni DiGirolamo, Friends of Bert McAlister. NETHERLANDS: Judy Landis. SOUTH AFRICA: Margot Burton. DISCLAIMER The information in this newsletter is not intended as a substitute for professional health care. VEDA does not advocate any particular course of treatment for any particular disorder. The opinions expressed in articles in On the Level are those of the authors and not necessarily those of On the Level, or the VEDA medical and scientific advisors, or the VEDA board of directors. LEGAL HELP Dennis Robben, a VEDA member, wrote to On the Level asking that we mention his attorney, Robert A. Friedman. "This attorney has a better than 85 percent success rate on Social Security claims," he wrote. "He has helped me, and he has helped several people in my support group." In a separate letter, Mr. Friedman noted that he handled Social Security and Veterans Affairs claims only for people in the Puget Sound area. Mr. Friedman's address is 3410 Broadway, Everett, Wash. 98201. His phone number is (206) 252-5551. BOOK REVIEW A Scientific Watergate -- Dyslexia By Harold N. Levinson, M.D. (Stonebridge, $24.95) If she doesn't need new glasses and she doesn't have brain damage, why can't Johanna read? Dr. Levinson's answer, which he first gave 21 years ago and has been defending since, is that many cases of so-called dyslexia are actually cases of vestibular damage. The vestibular problems cause visual tracking problems and other inner-ear signs, he says, such as poor coordination and balance, trouble with sense of direction, poor concentration, and motion sickness. Dr. Levinson claims to have cured none of these "dyslexic" patients; rather, he says, he has helped 25 percent significantly, 25 percent moderately, 25 percent mildly, and 25 percent not at all. He treats them with meclizine and other drugs, with eye exercises, vestibular therapy, and other means familiar to VEDA members. His unorthodox writing style and volleys of shot and shell against his detractors may make some readers think he's gone over the edge rather than pushing it forward. It's also possible that he's onto something big.