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Head injury and prolonged bed rest, but not inner ear disease, predict poorer outcome after Epley manoeuvre in posterior semicircular canal benign paroxysmal positional vertgo (P-BPPV)

This Japanese study included 197 patients with P-BPPV treated over a two and a half year period. The vast majority had idiopathic BPPV (n=157). The remaining 40 had secondary BPPV, eight following head trauma, 14 due to prolonged bed rest...

Measurement of HINTS in peripheral vestibulopathy

Dizziness; Head impulse test; Nystagmus; Skew deviation; Vertigo.

Recent changes in vestibular science and assessment

Clinical assessment of the dizzy or imbalanced patient is all about the patient’s history. History, history, history. But what about puzzling cases when we feel we need more information? Sally Rosengren gives us a rundown of the vestibular tests which...

A diagnostic survey of dizziness

The prevalence of self-reported dizziness and that requiring medical consultation is remarkably high. Cardiac and neuropathic comorbidities, often associated with these patients confuse the diagnosis. In this multicentre study, the prevalence and characteristics of various diagnostic groups, for example, Benign...

The Dilemma of Beethoven’s Deafness

Beethoven was one of the world’s greatest musicians, and his deafness is well known. Many details of his medical conditions are known, and various theories of his hearing loss have been proposed. Ludwig van Beethoven was born in 1770 in...

Vestibular rehabilitation therapy: diagnosis based strategies

In his second article on this topic (see here for the first article), Richard E Gans explains how to use vestibular rehabilitation therapy to treat vestibular patients, and demonstrates why this method of diagnosis based strategies has proved so successful....

Obstructive sleep apnoea in common vestibular disorders

The importance of getting a good night’s sleep is often acknowledged but may be particularly difficult to achieve for those with obstructive sleep apnoea (OSA). In addition to high blood pressure, increased risk of stroke and depression, balance problems may...

Is clinical HIT as good as vHIT in the emergency room?

Establishing the cause of acute vestibular syndrome (AVS) is critical in the first few hours of presentation in the emergency department. The first question to ask is, “is it due to a peripheral vestibular pathology or a stroke?” This is...

Clinical utility and practical interpretation of the video head impulse test

The head impulse test (HIT) is an essential bedside test to detect peripheral vestibular deficits. The video head impulse test (vHIT) is a new tool quantifying the HIT. In this article Maria Heuberger and colleagues point out the clinical utility...

From trauma to recovery: treatment at Defence Medical Rehabilitation Centre

This year (2014) is the centenary year of the beginning of the Great War. This conflict brought with it a cluster of emotional disorders that were called at the time, Shell-Shock. The present conflict in Afghanistan has been talked of...

Outcomes of temporal bone-resurfacing for pulsatile tinnitus associated with vascular wall anomalies

This month’s Ed’s choice is an interesting systematic review into the management of pulsatile tinnitus. There are impressive results from resurfacing of symptomatic anatomical abnormalities of the temporal bone and I suspect that referrals for further imaging and otology clinic...

Charles Skinner Hallpike and the Hallpike Prize

The British Association of Audiovestibular Physicians introduced the Hallpike Prize in 2009 as an award to stimulate the pursuit of knowledge in relation to the field of audiovestibular medicine. Julian Ahmed celebrates the history of the great man the award...