Otoneurology and Vestibular Medicine - A Clinical Handbook

This book covers the clinical evaluation, testing, and management of patients suffering from dizziness, which is an immense and underserved population.  It provides specialists (otolaryngologists, neurologists) and generalists (internal medicine, emergency medicine) with an accessible resource for diagnosing and managing these patients. 
After the Introduction, the book is divided into three sections. The first includes chapters on Diagnoses with each containing an overview followed by epidemiology, mechanism of disease, clinical history, physical examination, ocular motor examination, instrumented audiologic and vestibular testing, imaging, differential diagnosis, treatment and prognosis.  The second section has chapters focused on Testing, which includes particular physical examination techniques, instrumented oculomotor examination, otovestibular testing, and imaging. The chapters in the final section cover Treatments. 
The goal of this unique book is to present as much physiology as is needed to explain the mechanism of disease, why it presents in the way that it does, and the rationale for treatments.

List of contents

Introductory materials.- Part 1: Introductory materials:The field and the diagnostic process.- 1.The field and its practitioners, logistics and infrastructure.- 2. Symptom terminology. Does the description of “dizziness” matter? Triggers, timing, etc.- 3. Diagnostic thinking.- 4. Questionnaires.- 5. Preliminary diagnostic algorithm.- Part 2: Introductory materials — Physiology, phenomena and concepts.- 6. Overview of the auditory system.- 7. Overview of the vestibular system.- 8. Nystagmus, definition and characterization.- 9. Vestibulo-ocular reflex.- 10. Vestibular tuning spectrum.- Part 3: Introductory materials:Specific eye movements and their normative ranges.- 11. Spontaneous nystagmus, normative ranges.- 12. Saccades, normative ranges.- 13. Gaze evoked nystagmus, normative ranges.- 14. Smooth pursuit, normative ranges.- 15. Optokinetic nystagmus, normative ranges Diagnoses.- Part 4: Diagnoses:Diseases of the labyrinth.- 16. Benign paroxysmal positional vertigo (BPPV) in general.- 17. Posterior canal BPPV.- 18. Lateral canal BPPV.- 19. Anterior canal BPPV.- 20. Meniere’s disease.- 21. Otolithic catastrophe of Tumarkin.- 22. Post-traumatic endolymphatic hydrops.- 23. Autoimmune inner ear disease (AIED).- 24. Sympathetic ear disease.- 25. Noise induced hearing loss.- 26. Noise induced vestibular damage.- 27. Otic barotrauma.- 28. Presbycusis (age-related hearing loss).- 29. Ototoxicity.- 30. Inner ear ischemia.- 31. Labyrinthine ossification.- 32. Audio-vestibular symptoms following cochlear implantation.- Part 5: Diagnoses:Diseases of the vestibulo-cochlear nerve.- 33. Vestibular, cochlear, and vestibulocochlear paroxysmia.- 34. Vestibular schwannoma.- 35. Auditory neuropathy.- 36. Ramsay Hunt syndrome (herpes zoster oticus).- 37. Multiple myeloma.- Part 6: Diagnoses: Diseases involving the middle ear.- 38. Middle ear myoclonus (tensor tympani myoclonus, stapedial myoclonus).- 39. Eustachian tube dysfunction (ETD).- 40. Otitis media and middle ear effusion.- 41. Cholesteatoma.- 42. Glomus tympanicum.- Part 7: Diagnoses:Diseases potentially involving multiple otologic structures.- 43. Vestibular weakness in general.- 44. Bilateral vestibular weakness (BVW).- 45. Vestibular neuritis.- 46. Labyrinthitis.- 47. Sudden sensorineural hearing loss (SSNHL).- 48. A continuum of vestibular neuritis, labyrinthitis and sudden sensorineural hearing loss?.-49. Third window phenomena.- 50. Semicircular canal dehiscence (SCD).-51. Perilymphatic fistula (PLF).- 52. Idiopathic tinnitus.- 53. Exploding head syndrome.- 54. Pulsatile tinnitus.-55. Tinnitus related to temporomandibular joint dysfunction.-56. Tinnitus related to the neck (cervicogenic tinnitus).- 57. Otosclerosis.- 58. Paget’s disease of bone (osteitis deformans).- 59. Fibrous dysplasia.- 60. Labyrinthine concussion.- 61. Temporal bone fracture.- 62. Hyperacusis.- 63. Otalgia and referred otalgia.- Part 8: Diagnoses:Congenital otologic malformations.- 64. Large vestibular aqueduct.- 65. Large cochlear aqueduct.- 66. Mondini dysplasia.- 67. Pendred syndrome.- 68. Usher syndrome.- Part 9: Diagnoses:Diseases involving the brain, spinal cord and peripheral nerves.- 69. Migraine associated vertigo (MAV).- 70. Cyclic vomiting syndrome.-71. Motion sickness (constitutional motion sensitivity).- 72. Cybersickness.- 73. Motorist disorientation syndrome.- 74. Mal de debarquement syndrome (MdDs).-75. Persistent postural perceptual dizziness (PPPD).- 76. Concussion and post-concussive disequilibrium.- 77. Stroke and disequilibrium.- 78. White matter disease and disequilibrium.- 79. Encephalitis.- 80. Epileptic vertigo.- 81. Superficial siderosis.- 82. Cervicogenic vertigo (CV).- 83. Spinal cord disorders.- 84. Peripheral neuropathy in general.- 85. Charcot-Marie-Tooth disease.- 86. CANVAS (cerebellar ataxia, neuropathy, vestibular areflexia syndrome).- 87. Susac syndrome.- Part 10: Diagnoses:Ataxias.- 88. Spinocerebellar ataxias and other genetic ataxias.- 89. Episodic ataxias and acetazolamide responsive ataxias.- 90. Gluten ataxia.- 91. Friedreich ataxia.- Part 11: Diagnoses:Movement disorders.- 92. Parkinsonism.- 93. Idiopathic Parkinson’s disease.- 94. Progressive supranuclear palsy (PSP).- 95. Multiple system atrophy (MSA).- 96. Huntington’s disease.- 97. Stiff person syndrome (SPS).- 98. Fahr disease (FD).- Part 12: Diagnoses:Posterior fossa lesions.- 99. Chiari malformations.- 100. Basilar invagination.- 101. Paraneoplastic syndrome.- Part 13: Diagnoses:Intracranial pressure disorders.- 102. Hydrocephalus with increased intracranial pressure.- 103. Normal pressure hydrocephalus (NPH).- 104. Intracranial pressure fluctuations and hearing loss.- Part 14: Diagnoses:Neurologically-mediated visual disorders.- 105. Visual snow syndrome (VSS).- 106. Misokinesia.- Part 15: Diagnoses:Neurologically-mediated auditory disorders.- 107. Cortical deafness.- 108. Misophonia.- 109. Musical hallucinations.- Part 16: Diagnoses:Specific ocular motor syndromes.- 110. Centripetal nystagmus.- 111. Congenital nystagmus.- 112. Convergence-retraction nystagmus
113. Internuclear ophthalmoplegia (INO).- 114. Latent nystagmus.- 115. Opsoclonus and the opsoclonus myoclonus syndrome.- 116. Oculopalatal tremor.- 117. Periodic alternating nystagmus (PAN).- 118. Rebound nystagmus.- 119. See-saw nystagmus.- 120. Spontaneous down beat nystagmus.- 121. Spontaneous up beat nystagmus.- 122. Square wave jerks.- 123. Staircase saccades.- 124. Windmill nystagmus.- Part 17: Diagnoses:Eye movements elicited by specific provocative maneuvers.- 125. Head-shaking nystagmus.- 126. Hyperventilation-induced nystagmus.- 127. Valsalva-induced nystagmus.-  128. Vibration-induced nystagmus.- Part 18: Diagnoses:Other central nervous system pathologies.- 129. Neurologic disease processes that can involve any part of the central nervous system (infarction, demyelination, space-occupying lesions).- 130. Selected vascular phenomena in otoneurology.- Part 19: Diagnoses:Intersections between otovestibular disease, psychology and psychiatry.-
131. Psychological disequilibrium.- 132. Dissociative experiences in vestibular disorders.- 133. Psychiatric disease and vestibular dysfunction.- 134. Cognitive impairment and disequilibrium.- 135. Cognitive impairment and hearing loss.- 136. Cognitive impairment and tinnitus.- Part 20: Diagnoses — Ophthalmologic and visual factors in disequilibrium.- 137. Visual vertigo (VV).- 138. Ophthalmological visual deficits and disequilibrium.- 139. Superior oblique myokymia.- 140. Illusions of inversion and tilt.- Part 21: Diagnoses:Cardiovascular causes of disequilibrium.- 141. Orthostatic hypotension and postural orthostatic tachycardia.- 142. Orthostatic hypertension.- 143. Cardiac arrhythmia.- 144. Vestibular syncope.- Part 22: Diagnoses:Medical causes of disequilibrium.- 145. Pharmacologic causes of disequilibrium.- 146. Postprandial disequilibrium.- Part 23: Diagnoses:Infectious causes of disequilibrium.- 147. COVID-19.- 148. Epstein-Barr virus.- 149. Human immunodeficiency virus (HIV) and otovestibular symptoms.- 150. Lyme disease.- 151. Syphilis (otosyphilis).- Part 24: Diagnoses — Endocrinological, nutritional and metabolic causes of disequilibrium.- 152. Thyroid disease and disequilibrium.- 153. Vitamin B1 (thiamine) deficiency.- 154. Vitamin B12 (cyanocobalamin) deficiency.- 155. Vitamin D deficiency.- 156. Wilson’s disease.- 157. Zinc deficiency.- 158. Altitude sickness.- Part 25: Diagnoses:Toxic causes of disequilibrium.- 159. Alcohol.- 160. Heavy metals.- 161. Caffeine.- 162. Carbon monoxide.- 163. Cocaine.- 164. Marijuana (cannabis).- 165. MDMA (“ecstasy”).- 166. Nicotine and tobacco.- 167. Phencyclidine (PCP).- Part 26: Diagnoses:The role of electromagnetic fields and radiation in disequilibrium.- 168. Radiation and its otovestibular effects.- 169. Electromagnetic fields (EMFs).- Part 27: Diagnoses:Presentations with multiple potential causes.- 170. Multifactorial disequilibrium.- 171. Presbyvestibulopathy.- 172. Drop attacks.- 173. Coital vertigo.- Part 28: Diagnoses:Otovestibular symptoms occurring in the context of other conditions.- 174. Chronic fatigue syndrome (CFS) and otovestibular symptoms.- 175. Fibromyalgia and otovestibular symptoms.- 176. Ehlers-Danlos syndrome (EDS) and otovestibular symptoms.- 177. Pregnancy.- Part 29: Diagnoses:Immunologically-mediated otovestibular symptoms.- 178. Allergy and otovestibular symptoms.- 179. Lupus (systemic lupus erythematous) and otovestibular symptoms.- 180. Rheumatoid arthritis (RA) and otovestibular symptoms.- 181. Sarcoidosis and otovestibular symptoms.- 182. Scleroderma and otovestibular symptoms Evaluation.- Part 30: Evaluation:Bedside physical examination.- 183. Dynamic visual acuity testing.- 184. Ophthalmoscope test.- 185. Bedside head impulse testing.- 186. Otoscopy (handheld, monocular).- 187. Bedside hearing tests (finger rub, whisper, Weber, Rinne).- 188. Romberg test.- 189. Fukuda-Unterberger stepping test.- 190. Vertebral artery testing.- Part 31: Evaluation:Instrumented testing.- 191. Why do we do testing at all? Confidence and uncertainty.- 192. Binocular otomicroscopy.- Part 32: Evaluation:Audiometric testing.- 193. Audiometry.- 194. Stenger effect and Stenger test.- 195. Tympanometry.- 196. Otoacoustic emissions (OAEs).- 197. Auditory evoked brainstem responses (ABRs).- 198. Electrocochleography (ECoG).- Part 33: Evaluation:Ocular motor vestibular tests.- 199. Why do we look at eye movements?.- 200. Magnetic scleral search coils.- 201. Electronystagmography (ENG).- 202. Videonystagmography (VNG).- 203. Caloric testing.- 204. Video head impulse testing (vHIT) and its variants.- 205. Rotatory chair testing (RCT).- 206. Retinal imaging.- Part 34: Evaluation:Vestibular evoked myogenic potentials.- 207. General comments on vestibular evoked myogenic potentials.- 208. Cervical vestibular evoked myogenic potentials (cVEMPs).- 209. Ocular vestibular evoked myogenic potentials (oVEMPs).- Part 35: Evaluation:Other vestibular tests.- 210. Computerized dynamic posturography (CDP).- 211. Tests limited to research settings.- Part 36: Evaluation: Cardiovascular testing in otoneurology
212. Tilt table testing (TTT).- 213. Cardiac monitoring.- Part 37: Evaluation — Imaging in otoneurology.- 214. General comments about imaging in otoneurology.- 215. MRI of the brain and internal auditory canals.- 216. Temporal bone CT.- Part 38: Evaluation:Miscellaneous modalities.- 217. Telemedicine in otoneurology
Management.- Part 39: Management:General comments on pharmacological intervention.- 218. Comments on medication side effects.- Part 40: Management:Classes of pharmaceutical agents.- 219. Aminopyridines (4-AP, 3,4-DAP).- 220. Anti-nauseant and anti-emetic medications.- 221. Anti-oxidants.- 222. Benzodiazepines.- 223. Beta blockers.- 224. Botulinum toxins.- 225. cGRP inhibitors.- 226. Corticosteroids.- 227. Diuretics.- 228. Serotonin-norepinephrine reuptake inhibitors (SNRIs).- 229. Serotonin-specific reuptake inhibitors (SSRIs).- 230. Tricyclics.- Part 41: Management:Individual medications.- 231. Acetazolamide.- 232. Baclofen.- 233. Betahistine.- 234. Botulinum toxin.- 235. Dimenhydrinate.- 236. Fludrocortisone.- 237. Fluticasone and azelastine.- 238. Gabapentin.- 239. Meclizine.- 240. Melatonin.- 241. Memantine.- 242. Midodrine.- 243. Oxcarbazepine.- 244. Scopolamine.- 245. Topiramate.- 246. Trimetazidine.- 247. Venlafaxine.-.- 248. Verapamil.- Part 42: Management:Nutritional supplements.- 249. Coenzyme Q10. 250. Magnesium.- 251. Riboflavin.- 252. Vitamin D.- Part 43: Management:Herbal supplements.- 253. Butterbur.- 254. Feverfew.- Part 44: Management:Procedures, non-surgical.- 255. Acupuncture.- 256. Nerve blocks for headache.- 257. Transcutaneous electrical nerve stimulation (TENS).- 258. Transcranial magnetic stimulation (TMS).- 259. Vagal nerve stimulation (VNS).- 260. Hyperbaric oxygen therapy (HBOT).- Part 45: Management:Procedures, surgical.- 261. Tympanostomy tube placement.- 262. Transtympanic injections.- 263. Tympanoplasty.- 264. Silverstein MicroWick.- 265. Positive pressure therapies for Meniere’s disease.- 266. Labyrinthectomy and vestibular neurectomy.- 267. Surgery for superior semicircular canal dehiscence.- 268. Surgery for benign paroxysmal positional vertigo.- Part 46: Management:Vestibular rehabilitation therapy.- 269. General comments about physical therapy for benign paroxysmal positional vertigo (BPPV).- 270. Physical therapy for BPPV of the posterior canal, unilateral.- 271. Physical therapy for BPPV of the posterior canal, bilateral or unknown.- 272. Physical therapy for BPPV of the lateral canal (geotropic or apogeotropic), unilateral.- 273. Physical therapy for BPPV of the lateral canal, geotropic, unilateral.- 274. Physical therapy for BPPV of the lateral canal, apogeotropic, unilateral.- 275. Physical therapy for BPPV of the lateral canal (geotropic or apogeotropic), bilateral.- 276. Physical therapy for BPPV of the anterior canal, unilateral.- 277. Physical therapy for BPPV of the anterior canal, bilateral.- 278. Physical therapy for BPPV, other maneuvers.- 279. Mechanical chair treatment for benign paroxysmal positional vertigo.- 280. Physical rehabilitation therapy for vestibular weakness.- Part 47: Management:Therapies for the neck.- 281. Physical therapy for the neck.- 282. Chiropractic manipulation.- Part 48: Management:Other vestibular therapies.- 283. Motion desensitization (Puma method).  284. Mingjia Dai’s treatment for MdDs.- Part 49: Management:Auditory interventions.- 285. Hearing amplification.- 286. Hearing amplification, balance and falls.- 287. Treatment of idiopathic tinnitus.- Part 50:. Management:Other interventions.- 288. Vestibular compensation.- Part 51: Management:Bureaucratic issues.- 289. Provision of hearing aids.- 290. Functional capacity evaluation (FCE).- 291. Disability.- 292. Driving.

About the author

Marcello Cherchi, MD, PhD
Clinical Associate and Director of Otoneurology and Vestibular Medicine
University of Chicago Medicine
Department of Neurology
5841 South Maryland Avenue
Chicago, IL 60637.

Summary

This book covers the clinical evaluation, testing, and management of patients suffering from dizziness, which is an immense and underserved population.  It provides specialists (otolaryngologists, neurologists) and generalists (internal medicine, emergency medicine) with an accessible resource for diagnosing and managing these patients. 
After the Introduction, the book is divided into three sections. The first includes chapters on Diagnoses with each containing an overview followed by epidemiology, mechanism of disease, clinical history, physical examination, ocular motor examination, instrumented audiologic and vestibular testing, imaging, differential diagnosis, treatment and prognosis.  The second section has chapters focused on Testing, which includes particular physical examination techniques, instrumented oculomotor examination, otovestibular testing, and imaging. The chapters in the final section cover Treatments. 
The goal of this unique book is to present as much physiology as is needed to explain the mechanism of disease, why it presents in the way that it does, and the rationale for treatments.

Product details

• Authors: Marcello Cherchi
• Publisher: Springer International Publishing
• Languages: English
• Product format: Hardback
• Release: 05.08.2025
• EAN: 9783031948404
• ISBN: 978-3-031-94840-4
• Illustrations: Approx. 450 p. 40 illus., 20 illus. in color., schwarz-weiss Illustrationen, farbige Illustrationen
• Subjects: Natural sciences, medicine, IT, technology > Medicine > Clinical medicine; Management, Neurochirurgie, Neurowissenschaften, Vertigo, neurosurgery, Hals-Nasen-Ohren-Heilkunde, Otorhinolaryngology, Neurology, diagnosis, Neuroscience, dizziness, Vestibular Testing