And there are other items on that differential diagnosis list.
But one finding that's very reliable during an inner ear event is nystagmus, a rhythmic, involuntary eye movement in which the eyes dance back and forth in the patient's head. When you see it, as a diagnostician, it seals the diagnosis. Quite often it even tells us which ear the problem is arising in—not always an obvious thing. Treatment, now that the diagnosis is confirmed, can commence immediately.
The problem is the nystagmus is only visible during the event, which can be measured in minutes and sometimes a few hours. So early on in my practice, I found my inability to know what the eyes of my patients were doing during their dizzy attacks to be frustrating. I would write notes to their doctors that they would carry in their wallets and purses, asking them to document the eye movements of the patient if they presented with dizziness. But try getting in to see your family doctor in the next hour, or to see an emergency room doctor within six hours. It's very difficult.
Then one day something very interesting happened to me, and I hope to be able to share a version of it with you today. A lady came to see me for a second visit for her dizziness. I was convinced, having done my comprehensive history and physical examination on her first visit, both of which were normal, that she probably did not have a vestibular inner ear disorder. Two minutes after she sat down on the stretcher in my exam room, she did the most remarkable thing: she had an attack of Ménière's disease. She became very pale and distressed, she started to lean over at a funny angle, and her eyes started to beat very rapidly from right to left for 20 minutes
I learned a great many things in those 20 minutes, but the most important thing I learned was that my initial impression of that lady had been incorrect. Immediately afterwards I started to encourage my patients to shoot video of their eye movements during the height of their dizzy attacks.
I hope to be able to show you a version of this during the hearing.
After nine years of this pioneering work, started in Barrie, Ontario, by me, with my digital camera and now my smart phone, I have shared my observations with dizziness specialists across the country, and indeed with my Cambridge connections around the world. We have made many new medical discoveries in Barrie, Ontario, and we have seen things we could not explain, raising new questions where we did not realize we even had questions before.
If this will work, and if I am not out of time, I want to show you a very short—