A publication of medlogicai.org
Vertigo Teaching Atlas
An interactive teaching atlas of vestibular testing — VNG, nystagmus, VEMPs, vHIT and electrocochleography.
A seven-section curriculum in vestibular medicine — from the anatomy and physiology of the labyrinth, through bedside and instrumented evaluation, to the disorders, their treatments and the practical considerations that surround them.
42 of 42 chapters live. The remainder are in preparation and appear here as their scope is locked.
Section I
Foundations of Vestibular Science
Anatomy, physiology, and the mechanistic vocabulary that every later chapter assumes.
- Live
Anatomy of the Vestibular System
Semicircular canals, otolith organs, the vestibular nerve, central pathways and their clinical correlations.
- Live
Physiology of the Vestibular System
Fluid spaces and hair cells through the VOR, vestibulospinal reflexes and cerebellar modulation.
- Live
Pathophysiology of Vertigo
Mechanism, examination and management of peripheral and central vestibulopathies.
- Live
Understanding Vertigo Symptoms
Vertigo, presyncope, disequilibrium, nonspecific dizziness — and the functional syndromes.
- Live
Understanding Nystagmus
Library of nystagmus types and their localising value — peripheral, central, paroxysmal, gaze-evoked.
Section II
Clinical Evaluation
From the first question at the door to a working clinical hypothesis at the bedside.
- Live
History Taking in Vertigo
Timing, triggers, associated symptoms, red flags, and the HINTS and SO STONED algorithms.
- Live
Neuro-Ophthalmological Manifestations
Ocular-motor signs that separate central from peripheral — nystagmus, INO, skew/OTR, oscillopsia.
- Live
Bedside Clinical Tests in Vertigo
Dix-Hallpike, Supine Roll, head impulse, HINTS, Romberg, Fukuda, gait — the full bedside battery.
- Live
HINTS Bedside Exam
Head Impulse · Nystagmus · Test of Skew — the three-step protocol for acute vestibular syndrome.
- Live
Setting Up a Vertigo Clinic
Floor plan, 36-week timeline, equipment matrix, patient journey, cost breakdown and a setup checklist.
Section III
Diagnostic Tools and Techniques
Instrumented vestibular testing — each modality indexed by the clinical question it answers.
- Live
Videonystagmography (VNG)
Goggles-recorded battery: gaze, smooth pursuit, saccade, optokinetic, positional, bithermal caloric.
- Live
Video Head Impulse Test (vHIT)
Canal-specific gain testing for all six semicircular canals — covert and overt catch-up saccades.
- Live
Dynamic Visual Acuity (DVA)
Gaze stabilisation and the functional VOR — bedside, computerised and head-thrust DVA paradigms, normal findings, and the signatures of vestibular disease.
- Live
Rotational Chair Test
Sinusoidal harmonic acceleration and velocity-step testing — VOR gain, phase, symmetry and the time-constant of velocity storage, in health and across the vestibular disorders.
- Live
Vestibular Evoked Myogenic Potentials (VEMP)
Cervical and ocular VEMPs — technique, asymmetry ratios, and diagnostic patterns.
- Live
Subjective Visual Vertical (SVV)
The otolith-graviceptive sense of vertical — bucket and digital technique, dynamic SVV, normal thresholds, and the tilt signatures of the ocular tilt reaction, Wallenberg syndrome, and peripheral and central vestibular disease.
- Live
Posturography and Balance Function Testing
Computerised dynamic posturography in depth — SOT, MCT and ADT with interactive simulators, sensory integration, limits of stability, disease-specific patterns and clinical cases — alongside static and other balance-function tests and the wearable / VR / AI future.
- Live
Electrocochleography
SP/AP ratio in suspected endolymphatic hydrops — recording, waveform interpretation, and pitfalls.
- Live
Role of Imaging in Vertigo
MRI, CT, CTA/MRA, fMRI and PET — indications, protocols, characteristic findings, and the AI-augmented future.
Section IV
Common Vestibular Disorders
Condition-by-condition reference — diagnosis, evidence, and a defensible management plan.
- Live
Benign Paroxysmal Positional Vertigo (BPPV)
Diagnosis and management — Dix-Hallpike, Supine Roll, and the canalith repositioning manoeuvres.
- Live
Ménière's Disease
Diagnosis, medical and surgical management — from betahistine to endolymphatic sac surgery.
- Live
Vestibular Migraine
Bárány Society criteria and management — acute relief and preventive strategies.
- Live
Vestibular Neuritis and Labyrinthitis
Acute peripheral vestibulopathy — an interactive HINTS interpreter to separate it from stroke, corticosteroids, and rehabilitation.
- Live
Superior Semicircular Canal Dehiscence (SSCD)
The third-window syndrome — Tullio, Hennebert, the air–bone gap with preserved reflexes, VEMP thresholds, and surgical plugging.
- Live
Perilymphatic Fistula
Barotrauma-induced vertigo — the explosive/implosive mechanism, a contested diagnosis, and round/oval window repair.
- Live
Bilateral Vestibulopathy
Diagnosis and future directions — the Bárány Society criteria, caloric / vHIT / rotational-chair thresholds, the causes from gentamicin to CANVAS, and management from vestibular rehabilitation to the vestibular implant.
- Live
Cervicogenic Dizziness
Somatosensory balance dysfunction — pathophysiology, the cervical and vestibular work-up, a diagnosis of exclusion, imaging, and management with manual therapy and vestibular rehabilitation.
- Live
Autoimmune Inner Ear Disease
Immune-mediated vertigo — corticosteroid response, work-up, and immunomodulatory therapy.
- Live
Persistent Postural-Perceptual Dizziness (PPPD)
The commonest cause of chronic dizziness — the Bárány Society criteria, the post-event triggers and maladaptive postural control, and management with vestibular rehabilitation, SSRIs/SNRIs and CBT.
- Live
Mal de Débarquement Syndrome (MdDS)
Unique mechanisms and treatment — readaptation protocols and emerging therapies.
- Live
Central Causes: Stroke, MS, Tumours
Posterior-circulation stroke, demyelination, posterior-fossa tumours and other central pathology.
Section V
Treatment Approaches
Drugs, manoeuvres, rehabilitation, and surgery — how the disorder gets fixed.
- Live
Pharmacological Management of Vertigo
Antihistamines, antiemetics, benzodiazepines, betahistine, steroids — when and for how long.
- Live
Therapeutic Manoeuvres
Dix-Hallpike, Semont, Epley, Gufoni and beyond — by canal, with step-by-step animations.
- Live
Vestibular Rehabilitation Therapy
Gaze stabilisation, habituation, balance and substitution — programme design and customisation.
- Live
Surgical Management of Vertigo
Indications, techniques and controversies — labyrinthectomy, vestibular nerve section, plugging.
Section VI
Special Populations and Practical Applications
Children, the elderly, complex multidisciplinary cases, and the time-critical emergency presentation.
- Live
Vertigo in Paediatric and Elderly Populations
Age-specific differentials — BPPV of childhood, presbyvestibulopathy, and the falls connection.
- Live
Case-Based Discussion
Multidisciplinary management — neurology, ENT, audiology and vestibular physiotherapy together.
- Live
Emergency Management of Acute Vertigo
TiTrATE triage, the HINTS battery, ten conditions with first-hour management, and an AVS Decision Tool.
Section VII
Future Directions and Reference Aids
Where the field is going, and the reference apparatus that ties the whole atlas together.
- Live
Emerging Technologies
Vestibular implants, virtual reality, neuromodulation and gene therapy.
- Live
Glossary of Terms
Atlas-wide glossary — every defined term, linked to the chapter that introduces it.
- Live
List of Abbreviations
Master list of acronyms used across the atlas, with expansions and clinical glosses.
- Live
Index
Searchable index across all chapters — symptoms, signs, conditions and investigations.