Talk Dizzy To Me

In this episode of Talk Dizzy To Me, vestibular physical therapists Dr. Abbie Ross, PT, NCS and Dr. Dani Tolman, PT sit down with Dr. David Sandlin, a vestibular and oculomotor neurologist at Emory Brain Health Center, to discuss how eye movements can provide critical clues to progressive neurologic diseases.
From Parkinson's disease and Progressive Supranuclear Palsy (PSP) to Multiple System Atrophy (MSA), cerebellar disorders, and Multiple Sclerosis (MS), Dr. Sandlin explains how a detailed bedside eye movement examination can detect neurologic disease long before imaging does. He shares the clinical reasoning behind evaluating nystagmus, saccades, smooth pursuit, VOR testing, and other vestibular examination findings that help differentiate central from peripheral causes of dizziness.
This episode also discusses the importance of making timely referrals and understanding where vestibular rehabilitation fits into the care of progressive neurologic disorders.

Hosted by:
🎤 Dr. Abbie Ross, PT, NCS
🎤 Dr. Danielle Tolman, PT

For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠info@balancingactrehab.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Partnered with:
→ Our online program and community, The Dizzy Reset™, ⁠⁠⁠⁠use code TALKDIZZYTOME for 40% off your first payment⁠⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠Avulux glasses, use code DIZZYRESET for $25 off⁠⁠⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Just Ingredients, use code TALKDIZZYTOME for 5% off⁠⁠⁠⁠

Connect with Us:
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This episode is for educational purposes only and is not a substitute for medical advice. Always consult a qualified healthcare provider for diagnosis and treatment. The views expressed by guests are their own and do not necessarily reflect those of the hosts.

Time Stamps:
00:00 – Introduction to Dr. David Sandlin
02:15 – Why Dr. Sandlin specialized in vestibular & ocular motor neurology
06:05 – What are progressive neurologic diseases?
08:15 – Can dizziness be the first symptom?
10:55 – How Dr. Sandlin evaluates dizzy patients
12:45 – Eye movement examination: fixation, nystagmus & ocular alignment
15:35 – Saccades and what they reveal about the brain
18:25 – Smooth pursuit, convergence & VOR suppression
21:50 – Why eye movements reveal so much about neurologic disease
24:20 – Vestibular testing beyond the bedside exam
26:10 – Red flag patterns of nystagmus clinicians should recognize
28:55 – Hypermetric saccades, stroke & cerebellar findings
30:20 – Pendular nystagmus and multiple sclerosis
32:10 – MRI: when imaging helps—and when your clinical exam is better
36:45 – Central vs. peripheral findings: what provides reassurance?
41:45 – Progressive Supranuclear Palsy (PSP): recognizing early signs
45:10 – Multiple System Atrophy (MSA), Parkinsonism & autonomic dysfunction
49:20 – AI, ChatGPT & patients researching their symptoms
51:00 – The future of AI-assisted eye movement analysis
53:00 – Virtual reality and the future of vestibular diagnostics
56:25 – Key takeaways for patients and clinicians

In this episode of Talk Dizzy to Me, vestibular physical therapists Dr. Abbie Ross, PT, NCS and Dr. Dani Tolman, PT are joined by Dr. Ben Shaw, a London-based consultant audiovestibular physician specializing in dizziness, vertigo, balance disorders, tinnitus, and hearing loss.

Dr. Shaw explains how he evaluates patients with vague, recurrent, or chronic dizziness and why understanding the timing, triggers, and associated symptoms is essential for reaching the correct diagnosis.

The conversation discusses various vestibular conditions, including Benign Paroxysmal Positional Vertigo (BPPV), vestibular migraine, Ménière’s disease, vestibular neuritis, labyrinthitis, Persistent Postural-Perceptual Dizziness (3PD/PPPD), and Cerebellar Ataxia, Neuropathy, and Vestibular Areflexia Syndrome (CANVAS).

The episode also includes an in-depth discussion of tinnitus. Dr. Shaw explains why tinnitus is a symptom rather than a diagnosis and presents a holistic approach to tinnitus management.

Hosted by:
🎤 Dr. Abbie Ross, PT, NCS
🎤 Dr. Danielle Tolman, PT

For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠info@balancingactrehab.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Partnered with:
→ Our online program and community, The Dizzy Reset™, ⁠⁠⁠use code TALKDIZZYTOME for 40% off your first payment⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠Avulux glasses, use code DIZZYRESET for $25 off⁠⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠Just Ingredients, use code TALKDIZZYTOME for 5% off⁠⁠⁠

Connect with Us:
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Book a free call with us⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
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→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join our online program and community, The Dizzy Reset™⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
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This episode is for educational purposes only and is not a substitute for medical advice. Always consult a qualified healthcare provider for diagnosis and treatment. The views expressed by guests are their own and do not necessarily reflect those of the hosts.

Time Stamps
00:15 Meet Dr. Ben Shaw
01:34 Audiovestibular medicine explained
02:53 Evaluating dizziness
06:12 The vestibular examination
07:59 When additional testing is needed
08:55 Central red flags
10:23 Vestibular migraine and PPPD
11:49 Vestibular neuritis
12:19 Ménière’s disease
13:44 Neuritis vs. labyrinthitis
16:04 Understanding tinnitus
18:27 Managing tinnitus
20:46 CBT, mindfulness, and habituation
22:39 Tinnitus red flags
23:07 Sudden hearing loss
24:28 Pulsatile and unilateral tinnitus
25:28 Complex dizziness cases
25:58 CANVAS syndrome
27:53 Vestibular migraine and anxiety case
29:21 Treating migraine before vestibular rehab
31:19 Advice for clinicians
34:41 What patients should know about vertigo
36:04 Vestibular suppressant medications
37:03 Preventing vestibular migraine
37:56 Connect with Dr. Ben Shaw
39:21 Closing thoughts

In this episode of Talk Dizzy To Me, vestibular physical therapists Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman, PT are joined by Dr. Katherine Deines, PT, NCS and Dr. Jaimy Wahab, PT, NCS, also known as the Neuro Dizzy Duo, for a deep dive into one of the most overlooked parts of the vestibular system: the otolith organs.
While many people associate vertigo and dizziness with the semicircular canals and spinning sensations, this episode explores how the utricle and saccule help us sense gravity, acceleration, head position, vertical orientation, and linear movement. The conversation highlights why otolith dysfunction may contribute to symptoms such as rocking, swaying, bobbing, feeling pulled or pushed, floating, walking on marshmallows, disorientation, and feeling “off.”
The guests also explain how otolith dysfunction may show up in conditions such as BPPV, vestibular migraine, PPPD/3PD, Mal de Débarquement Syndrome, concussion, dysautonomia, POTS, Parkinson’s disease, and other complex vestibular presentations.
This episode is especially helpful for vestibular clinicians, physical therapists, audiologists, patients with chronic dizziness, and anyone trying to better understand why dizziness is not always “spinning.”

Episode Resources:
Where to find The Dizzy Duo on Instagram: @neuro_dizzy_duo
Email address:  info@neurodizzyduo.com
Courses, publications, or resources:
Their Positive Spin on Dizziness advanced vestibular courses cover many lesser discussed topics:otolith dysfunction, the difference between vestibular dysfunction and hypersensitivity, visual motion hypersensitivity, Vestibular Migraine, Mal de Debarquement Syndrome, Meniere’s disease
Recommended products or links: https://www.reactiveeducation.com/store

Hosted by:
🎤 Dr. Abbie Ross, PT, NCS
🎤 Dr. Danielle Tolman, PT

For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠info@balancingactrehab.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Partnered with:
→ Our online program and community, The Dizzy Reset™, ⁠⁠use code TALKDIZZYTOME for 40% off your first payment⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠Avulux glasses, use code DIZZYRESET for $25 off⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠Just Ingredients, use code TALKDIZZYTOME for 5% off⁠⁠
Connect with Us:
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Book a free call with us⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Get free resources straight to your inbox⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join our online program and community, The Dizzy Reset™⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
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→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Enjoying the podcast? Leave us a review!

This episode is for educational purposes only and is not a substitute for medical advice. Always consult a qualified healthcare provider for diagnosis and treatment. The views expressed by guests are their own and do not necessarily reflect those of the hosts.

Episode Timestamps:
01:36 – Jaimy's introduction
03:28 – Katherine’s introduction
06:38 – Why otolith organs are often overlooked
09:21 – Why dizziness is not always spinning
12:38 – Conditions linked to otolith dysfunction
16:42 – Otoliths, dysautonomia, POTS, and concussion
21:28 – Understanding linear vertigo and non-spinning dizziness
22:23 – How clinicians assess otolith function
25:14 – Why patient descriptions matter
27:28 – Using weights to help patients feel grounded
30:16 – Individualizing vestibular rehab treatment
31:37 – Head tilts, balance, and otolith-based exercises
35:22 – How much weight may help without overdoing it
39:52 – Vibration plates, BPPV, and vestibular concerns
42:15 – Avoiding overreliance on tools and strategies
44:33 – Astronauts, gravity, and otolith function
46:28 – Key takeaways for vestibular clinicians
52:05 – Key takeaways for patients with dizziness
53:21 – Final thoughts and closing

In this episode of Talk Dizzy To Me, vestibular physical therapists Dr. Abbie Ross, PT, NCS and Dr. Danielle Tolman, PT sit down with neurologist Dr. Kristen Steenerson to unpack Persistent Postural Perceptual Dizziness, also known as 3PD or PPPD.
If you feel dizzy, floaty, rocking, disoriented, or visually overwhelmed most days — especially in places like grocery stores, airports, busy restaurants, or while scrolling screens — this episode explains what may be happening in the brain and nervous system.
Dr. Steenerson breaks down the diagnostic criteria for 3PD, why symptoms can continue even after the original vestibular problem improves, how 3PD overlaps with vestibular migraine, and why treatment often requires a combination of education, vestibular therapy, medication, cognitive strategies, lifestyle support, and gradual exposure.
This conversation also addresses why 3PD is sometimes misunderstood, how hypervigilance plays a role, and why there is real hope for recovery and improved quality of life.

Hosted by:
🎤 Dr. Abbie Ross, PT, NCS
🎤 Dr. Danielle Tolman, PT

For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠info@balancingactrehab.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Partnered with:
→ Our online program and community, The Dizzy Reset™, ⁠use code TALKDIZZYTOME for 40% off your first payment⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠Avulux glasses, use code DIZZYRESET for $25 off⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠Just Ingredients, use code TALKDIZZYTOME for 5% off⁠

Connect with Us:
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Book a free call with us⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Get free resources straight to your inbox⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join our online program and community, The Dizzy Reset™⁠⁠⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
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→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Enjoying the podcast? Leave us a review!⁠⁠⁠⁠⁠
This episode is for educational purposes only and is not a substitute for medical advice. Always consult a qualified healthcare provider for diagnosis and treatment. The views expressed by guests are their own and do not necessarily reflect those of the hosts.
Timestamps:00:00 – Welcome to Talk Dizzy To Me
00:15 – Introducing Dr. Kristin Steenerson
01:10 – What is 3PD/PPPD?
01:37 – Diagnostic criteria: persistent, postural, perceptual dizziness
02:47 – Common triggers and risk factors
04:52 – Why some providers question the diagnosis
06:34 – Hypervigilance and lack of biomarkers
08:20 – Why symptoms can continue after the original issue resolves
09:35 – Education, reassurance, and moving from “detective mode” to rehab
11:24 – Brain health habits: sleep, food, exercise, hydration, stress
12:16 – Why symptom tracking can sometimes backfire
15:38 – Why grocery stores, airports, screens, and busy spaces trigger symptoms
17:47 – Fear, memory, and the brain’s threat response
19:39 – Avoidance vs gradual exposure
21:03 – Neurology evaluation and ruling out other causes
23:24 – What vestibular testing can and cannot show
25:14 – The gap in measuring perception
26:34 – fMRI research and brain network changes in 3PD
29:51 – Vestibular therapy for 3PD
31:00 – Medication options and why SSRIs/SNRIs may help
35:38 – 3PD vs vestibular migraine
41:05 – What progress looks like in recovery
43:49 – Permission to do hard things without fear of damage
44:47 – Community support and celebrating wins
45:42 – Future research: medications, CGRP, TMS, neuromodulation
48:54 – Mic drop takeaway for clinicians and patients

In this episode of Talk Dizzy To Me, Dr. Dani Tolman, PT and Dr. Abbie Ross, PT, NCS welcome back Sarah Renberg for her third appearance on the podcast. Sarah shares an inspiring update on her journey after a traumatic brain injury (TBI), vestibular dysfunction, autonomic dysfunction, ocular motor challenges, and more — and how she is now navigating medical school while continuing to manage her health. Sarah offers a powerful patient perspective on recovery, self-advocacy, support systems, and redefining progress after brain injury.

Episode Resources:
-Instagram: @Sren20
-Sarah’s 1st TDTM Episode 2021
-Sarah’s 2nd TDTM Episode 2023 

Sarah’s Team on TDTM:
-Dr. Appelbaum
-Dr. Keiser

Hosted by:
🎤 Dr. Abbie Ross, PT, NCS
🎤 Dr. Danielle Tolman, PT

For episode recommendations or requests, email us at: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠info@balancingactrehab.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Partnered with:
→ Our online program and community, The Dizzy Reset™, use code TALKDIZZYTOME for 40% off your first payment⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠Avulux glasses, use code DIZZYRESET for $25 off⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠Just Ingredients, use code TALKDIZZYTOME for 5% off

Connect with Us:
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Book a free call with us⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Get free resources straight to your inbox⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join our online program and community, The Dizzy Reset™⁠⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Watch podcast episodes (and more) on YouTube ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Follow us on Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
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→ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Enjoying the podcast? Leave us a review!⁠⁠⁠⁠

Timestamps:
00:58 — Sarah’s TBI, vestibular symptoms & surgical history
02:53 — Understanding symptoms and protecting self-worth
04:40 — How the visual, vestibular, neck & autonomic systems connect
07:02 — Support systems & asking for help
12:31 — Identity shifts after brain injury
13:54 — Resilience vs. “recovery”
16:46 — Embracing hard moments without getting stuck
17:46 — Building systems and routines for success
20:06 — Navigating plateaus, setbacks & goals
22:21 — Rehab habits, consistency & reducing barriers
24:41 — Redefining progress and celebrating small wins
28:30 — Getting through low moments
31:50 — Managing grocery stores and sensory overload
35:43 — Self-advocacy in healthcare appointments
41:26 — What Sarah would tell her 2014 self
46:01 — Being brave enough to try
48:23 — A message for clinicians
49:23 — Resources, where to find Sarah & closing

This episode is for educational purposes only and is not a substitute for medical advice. Always consult a qualified healthcare provider for diagnosis and treatment. The views expressed by guests are their own and do not necessarily reflect those of the host(s).