The pediatric section begins with a review of vestibular embryology and physiology and moves toward a comprehensive discussion of methods – both bedside and in the vestibular lab - to evaluate the child with dizziness, or “clumsiness,” concluding with an exploration of the differential diagnosis of dizziness and relevant findings. Dizziness in the adolescent points to migraine headache as a common cause, enumerates treatment strategies for migraine-associated vertigo, and offers guidelines for when to image the adolescent with dizziness.
Adult dizziness is more a compilation of the relevant diagnoses, but the section starts with dizziness that can affect young adults – especially members of our Armed Forces fighting overseas – traumatic brain injury/blast injury. This content also has relevance for patients in
motor vehicle accidents and head injury patients. Medicolegal aspects of evaluation and management of dizzy patients are succinctly
covered in “Evaluation of Dizziness in the Litigating Patient.” The final chapter in this section, “Other Causes of Dizziness,” provides
a very thorough overview of unusual causes of dizziness in the adult population.
Dizziness associated with advancing age is quite common and often multifactorial, as is highlighted in the chapter “Dizziness in the
Elderly.” A comprehensive review of the posterior cerebral circulation, transient ischemic attacks, and posterior circulation stroke is
presented in the chapter, “Vertebrobasilar Insufficiency.” No coverage of dizziness in the elderly is complete without an exposition of polypharmacy and medication effects. Other common diagnoses of dizziness in the elderly are thoughtfully reviewed along with a survey
of new and old techniques to rehabilitate the older patient with dizziness or disequilibrium.
Patients presenting with dizziness can harbor serious, if not life-threatening, conditions such as stroke, brain abscess, or severe chronic
ear disease. At the end of several articles, the reader will find a relevant table – What Not To Miss – a list of clinically significant signs
and symptoms not to ignore, or conditions (differential diagnosis) that may masquerade as that discussed in the chapter but critically
important that the practitioner should not overlook in the evaluation of the patient. Many articles in this edition start with a clinical
scenario so the reader can recognize common presenting symptoms, demographic features, and factors in the medical history that
will aid in making the diagnosis.
Key topics in balance function testing are addressed, such as indications for testing, what these tests can and cannot reveal, as well as the basics on how these tests are performed and interpreted.
The first six chapters cover procuring a thorough patient history, examination techniques, computerized testing, radiological studies, surgical anatomy and physiology of the vestibular system, and laboratory testing. Subsequent chapters concisely detail the diagnosis and treatment of pathologies such as Meniere's disease, benign paroxysmal positional vertigo, labyrithinitis, superior semicircular canal dehisence syndrome, and unilateral peripheral vestibulopathy.
Key FeaturesCovers the full age continuum - from congenital and pediatric vestibular disorders - to balance conditions associated with agingHighlights the most common pathologies such as BPPV, as well as fairly rare diseases like Mal de Debarquement syndrome and perilymph fistulasDiscusses the impact of alcohol, migraines, and allergies on the vestibular system and the intrinsic roles they play in causing dizzinessNew insights on medications, rehabilitation, and the use of implantable vestibular devicesExpanded video library provides guidance on testing modalities, visual disturbances, nystagmus patterns, and specific disorders
Physicians who read this authoritative guide will gain knowledge that is essential for optimal management of patients with vertigo and disequilibrium. It is an invaluable resource for otolaryngologists, as well as neurologists, physical therapists, internists, geriatricians, family practitioners, audiologists, and even cardiologists.