ABSTRACT
Symptoms of vertigo/dizziness and related off-balance sensations are some of the commonest in general medical practice and neurology. When a patient reports episodes of frank vertigo in which they feel that they or the world is spinning, a clinician is correct to consider vestibular disease as a likely diagnosis. Patients reporting that they feel unsteady on their feet or afraid of walking outdoors unaided may also suffer from a vestibular disorder. However, even when there is in the background a history of clear cut rotational vertiginous episodes, but even worse when there is no such past history, attaining a certain diagnosis can be difficult. Matters are complicated further by the fact that that patients with long-standing vertiginous symptoms become anxious, a feature that can frequently impede the possibility of achieving a firm diagnosis. An accurate neuro-otological examination can help to identify if the cause of a balance disorder is due to dysfunction of the vestibular system. The problem of falls in vestibular disease is discussed in Chapter 9.
