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This book provides a framework for understanding the pathophysiology of diseases involving the vestibular system. The book is divided into four parts: I. Anatomy and physiology of the vestibular system; II. Evaluation of the dizzy patient; III. Diagnosis and management of common neurotologic disorders; and IV. Symptomatic treatment of vertigo. Part I reviews the anatomy and physiology of the vestibular system with emphasis on clinically relevant material. Part II outlines the important features in the patient's history, examination, and laboratory evaluation that determine the probable site of lesion. Part III covers the differential diagnostic points that help the clinician decide on the cause and treatment of the patient's problem. Part IV describes the commonly used antivertiginous and antiemetic drugs and the rationale for vestibular exercises. The recent breakthroughs in the vestibular sciences are reviewed. This book will helpful to all physicians who study and treat patients complaining of dizziness.
PART 1 ANATOMY AND PHYSIOLOGY OF THE VESTIBULAR SYSTEM 1. OVERVIEW OF THE VESTIBULAR SYSTEM ANATOMY AND PHYSIOLOGY PERIPHERAL VESTIBULAR RECEPTORS CENTRAL VESTIBULAR PATHWAYS VESTIBULAR REFLEXES MOTION PERCEPTION AND ORIENTATION PATHOPHYSIOLOGY OF VESTIBULAR SYMPTOMS CENTRAL COMPENSATION FOR VESTIBULAR LESIONS SUMMARY 2. THE PERIPHERAL VESTIBULAR SYSTEM TEMPORAL BONE INNER EAR (LABYRINTH) THE HAIR CELL THE INNER EAR VESTIBULAR RECEPTORS PRIMARY VESTIBULAR NEURONS EFFERENT VESTIBULAR NEURONS 3. THE CENTRAL VESTIBULAR SYSTEM VESTIBULAR NUCLEI VESTIBULO-OCULAR REFLEXES CERVICO-OCULAR REFLEXES VISUAL-VESTIBULAR INTERACTION VESTIBULOSPINAL REFLEXES SUBJECTIVE VESTIBULAR SENSATION 4. EPIDEMIOLOGY OF DIZZINESS SPECIFIC DISORDERS BURDEN ON PATIENTS HEALTH CARE UTILIZATION SUMMARY PART 2 EVALUATION OF THE DIZZY PATIENT 5. THE HISTORY OF THE DIZZY PATIENT VERTIGO NEAR-FAINT DIZZINESS PATHOPHYSIOLOGIC DIZZINESS (CHRONIC SUBJECTIVE DIZZINESS) DRUG-INDUCED DIZZINESS HYPOGLYCEMIA DISEQUILIBRIUM OCULAR DIZZINESS MULTISENSORY DIZZINESS PHYSIOLOGIC DIZZINESS SUMMARY: DISTINGUISHING BETWEEN VESTIBULAR AND NONVESTIBULAR TYPES OF DIZZINESS 6. BEDSIDE EXAMINATION OF THE VESTIBULAR SYSTEM EXAMINATION OF THE EAR TESTS OF VESTIBULOSPINAL REFLEXES TESTS OF VESTIBULO-OCULAR REFLEXES TESTS FOR PATHOLOGIC NYSTAGMUS TYPES OF PATHOLOGIC NYSTAGMUS OTHER OCULAR OSCILLATIONS OCULAR TILT REACTION 7. LABORATORY EXAMINATIONS OF THE VESTIBULAR SYSTEM NYSTAGMOGRAPHY ROTATIONAL TESTING OF VESTIBULO-OCULAR REFLEXES VISUAL-VESTIBULAR INTERACTION TESTS OF OTOLITH-OCULAR REFLEXES VESTIBULOSPINAL TESTING VESTIBULAR-EVOKED POTENTIALS 8. CLINICAL EVALUATION OF HEARING TYPES OF HEARING DISORDERS BEDSIDE TESTS OF HEARING BEHAVIORAL AUDIOMETRY IMPEDANCE AUDIOMETRY TYMPANOMETRY AUDITORY-EVOKED RESPONSES GENERATING POTENTIALS TEST METHODOLOGY RESULTS IN PATIENTS CENTRAL AUDITORY SPEECH TESTS SUMMARY OF AUDITORY TEST RESULTS PART 3 DIAGNOSIS AND MANAGEMENT OF COMMON NEUROTOLOGIC DISORDERS 9. INFECTIOUS DISEASES ACUTE OTITIS MEDIA AND OTOMASTOIDITIS CHRONIC MASTOIDITIS AND CHOLESTEATOMA BACTERIAL LABYRINTHITIS PETROSITIS INTRACRANIAL EXTENSION OF EAR INFECTIONS MALIGNANT EXTERNAL OTITIS VIRAL INFECTIONS OF THE INNER EAR SYPHILITIS INFECTIONS OF THE EAR TUBERCULOSIS AND MYCOTIC INFECTIONS OF THE INNER EAR 10. BENIGN POSITIONAL VERTIGO HISTORICAL BACKGROUND CAUSES OF BPV POSTERIOR CANAL VARIANT OF BENIGN POSITIONAL VERTIGO OTHER VARIANTS OF BENIGN POSITIONAL VERTIGO 11. ENDOLYMPHATIC HYDROPS (MENIERE'S SYNDROME) BACKGROUND OCCURRENCE CLINICAL FEATURES PATHOPHYSIOLOGY ANIMAL MODELS ETIOLOGY DIAGNOSIS MANAGEMENT 12. MIGRAINE BACKGROUND CLINICAL FEATURES PATHOPHYSIOLOGY DIAGNOSIS MANAGEMENT 13. IMMUNE-MEDIATED DISEASES AUTOIMMUNE INNER EAR DISEASE PARANEOPLASTIC IMMUNE DISORDERS MULTIPLE SCLEROSIS 14. VASCULAR DISORDERS VERTEBROBASILAR ISCHEMIA INTRALABYRINTHINE HEMORRHAGE HEMORRHAGE INTO THE BRAIN STEM AND CEREBELLUM VASCULAR COMPRESSION SYNDROMES 15. TUMORS TUMORS OF THE MIDDLE EAR AND TEMPORAL BONE TUMORS OF THE INTERNAL AUDITORY CANAL AND CEREBELLOPONTINE ANGLE BRAIN TUMORS 16. TRAUMA TRAUMA TO THE TEMPORAL BONE PERILYMPH FISTULA SEMICIRCULAR CANAL DEHISCENCE SYNDROME BRAIN TRAUMA 17. TOXIC/METABOLIC DISORDERS DIZZINESS AND SYSTEMIC METABOLIC DISORDERS METABOLIC DISORDERS OF THE TEMPORAL BONE OTOTOXINS NEUROTOXINS 18. DEVELOPMENTAL AND GENETIC DISORDERS THE INNER EAR DISORDERS OF THE CRANIAL VERTEBRAL JUNCTION INHERITED SPINOCEREBELLAR ATAXIA SYNDROMES PART 4 SYMPTOMATIC TREATMENT OF VERTIGO 19. ANTIEMETIC AND ANTIVERTIGO DRUGS VESTIBULAR SUPPRESSANTS ANTIEMETIC DRUGS SPECIFIC DRUGS 20. VESTIBULAR REHABILITATION ADAPTIVE CONTROL OF NORMAL VESTIBULAR REFLEXES MECHANISMS FOR COMPENSATION AFTER VESTIBULAR LOSS SPECIAL CIRCUMSTANCES CONTROLLED TRIALS OF VESTIBULAR EXERCISES STRATEGY FOR DESIGNING VESTIBULAR EXERCISES VESTIBULAR EXERCISES FUTURE DIRECTIONS APPENDIX 20-1. SAMPLE HOME EXERCISE PROGRAM 21. FUTURE DIRECTIONS Index
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