Ian Purcell MD PHD
Otoneurology
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Dizzy Doctor

Dr. Purcell "Dizzy Doctor"

Gain deeper insights into the career and achievements of Dr. Ian Purcell, including his detailed CV and professional journey.
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About Dr. Purcell
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The "Dizzy Doctor"
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🌎 Dizzy Doctor Around the world

DizzyDoctor Systems

Explore Dr. Purcell’s innovative efforts in vestibular science, enhancing global understanding and treatment of balance disorders. Learn more about the technologies and methodologies transforming patient care worldwide.
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Vertigo Recording Goggles
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106.5512
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50.5577
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21.4389
158.0001
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156.7886
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117.1994

Dr. Purcell's Global Mission

Discover the locations and initiatives where Dr. Purcell has made significant impacts on vestibular health.
858 223 2172
858 223 2172
Educational Resources
Orthostatic Hypotension

Orthostatic Hypotension

(click to enlarge)

Orthostatic hypotension represents a significant drop in blood pressure upon standing, often observed in elderly patients. It's clinically marked by a decrease in systolic blood pressure by at least 20mm Hg or diastolic blood pressure by 10mm Hg within three minutes of standing. This condition highlights a failure in the body's complex regulatory system to compensate for gravity-induced blood pressure reductions.

Symptoms include:

  • Lightheadedness
  • Disequilibrium
  • Blurred vision or “browning-out”
  • Weakness
  • Fatigue
  • Cognitive impairment
  • Syncope (fainting)

Improvement is typically seen when returning to sitting, lying down, or standing with support.

Causes of Orthostatic Hypotension

Orthostatic hypotension can stem from neurogenic and non-neurogenic origins:

Neurogenic causes:

  • Peripheral neuropathy (e.g., diabetes, autoimmune diseases)
  • Parkinson’s disease
  • Multiple system atrophy
  • Pure autonomic failure
  • Lewy body dementia
  • Multiple sclerosis
  • Postural orthostatic tachycardia syndrome (POTS)

Non-neurogenic causes:

  • Cardiac impairment (e.g., myocardial infarction, aortic stenosis)
  • Dehydration
  • Adrenal insufficiency
  • Vasodilation (e.g., fever)
  • Medications like diuretics, alpha-blockers for BPH, antihypertensives, and calcium channel blockers

Diagnosing Orthostatic Hypotension

Diagnosis involves a tilt test or a tilt table test, monitoring blood pressure and heart rhythm from lying to standing positions, identifying significant changes that confirm orthostatic hypotension.

Managing Orthostatic Hypotension

Management aims at elevating standing blood pressure without adversely affecting supine blood pressure, focusing on reducing symptoms and improving daily activity tolerance. Strategies include:

  • Abdominal compression and compression stockings
  • Boluses of water for rapid symptom relief
  • Bed elevation to mitigate morning symptoms
  • Countermaneuvers like leg crossing and thigh muscle contraction
  • Medication adjustments, considering fludrocortisone and midodrine
  • Education on symptom triggers and management
  • Exercise, favoring mild, recumbent activities
  • Fluid and salt intake adjustments for optimal plasma volume

Read More

Neuromuscular Disorders
Seizure Disorders
Cupulolithiasis
Memory Loss/Dementia
Post-Concussive Syndrome/Traumatic Brain Injury
Normal Pressure Hydrocephalus
Acoustic Schwannomas
Vestibular Rehabilitation
Migraine Variant
Cardiac Arrhythmias
Nystagmus
Parkinson's Disease
Vestibular Migraine
Presbyastasis
Tinnitus
Sleep Apnea
Meniere's Disease
Viral Neuronitis & Labyrinthitis
Benign Paroxysmal Positional Vertigo (BPPV)
Dizziness
Ian Purcell MD PHD
Otoneurology

We are a specialty Oto-Neurology practice focusing on complex vertigo and balance disorders.

OUR Location

7625 Mesa College Drive
Suite 200A
San Diego, CA 92111

Contact

PHONE:
  • (858) 223-2172
FAX:
  • (858) 533-8397
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  • 858-223-2172
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