Diagnostic Vestibular Pocket Guide: Evaluation of Dizziness, Vertigo, and Imbalance

Review by L Flood
Middlesborough, UK

As per the title, this is a paperback easy reference guide, which, for once, will actually fit in many a pocket. It is ideally suited to a ‘dipping in’ or browsing approach, rather than reading from cover to cover in one sitting. The format, with boxed and highlighted text, many an algorithm, table or line diagram, and clinical applicability does immediately appeal.

The content is conventional, with coverage of the basic sciences, clinical evaluation and interpretation of the many objective tests of vestibular function now widely available, whether a rotatory chair or ice water in the ear canal! I would single out for praise the chapter on history taking (especially ‘Building up Rapport and Setting up the Visit Agenda’) or that on ‘basic’ clinical examination in the office setting. These two chapters alone commend the book to any trainee in otology or neurology. You would expect, and sure enough get, coverage of the most sophisticated objective testing, such as electronystagmography, the rotational chair, the video head impulse test and vestibular-evoked myogenic potentials. The applicability, methodology and interpretation of each is described in an understandable fashion, and that is no easy feat. Listing them does remind me of my amusement at reading three pages of ‘Common Abbreviations’ and our tendency to use such jargon, but one must admit that ‘POTS’ does have advantages over postural orthostatic tachycardia syndrome.

A particularly well thought out chapter emphasises how the entire clinical approach is modified according to the patient’s age, whether in childhood or advanced ‘maturity’.

The book closes with an appendix, which tabulates the symptom characteristics, clinical signs, pathophysiology and management options for a series of disorders. It is notable that this is supported by a list of references almost exclusively post 2015. This is a well updated book throughout.

This is not the easiest subject to master, but this is a very good introduction, and it is ideally suited to repeated reference by the novice.