Case Simulator
Work through realistic vertigo presentations. Each case unfolds as in clinic — history, then exam, then tracings, with questions at the decision points.
The woman who can't roll over
A 52-year-old wakes with vertigo every time she rolls in bed. Episodes last <30 seconds and she is well between them.
The HINTS-positive emergency
A 68-year-old man arrives with sudden vertigo, nausea, and gait imbalance. The HINTS exam will decide whether he goes home or to the stroke unit.
Recurrent vertigo with hearing loss
A 45-year-old reports episodes of vertigo lasting hours, with ear fullness and fluctuating hearing in the left ear.
The young woman with double vision
A 28-year-old reports horizontal diplopia worse on lateral gaze, with mild imbalance. Eye exam reveals a localizing sign.
Six months of dizziness — but the exam is normal
A 38-year-old has felt persistently dizzy since recovering from a vestibular event last year. Vestibular tests are normal.
The musician who hears her own footsteps
A 40-year-old violinist reports vertigo and a strange auditory experience: hearing her own heartbeat, footsteps, and even her eye movements.
Recurrent vertigo with fluctuating hearing — but it doesn't quite fit
A 38-year-old has episodic rotational vertigo with mild aural fullness. Some attacks have headache, some don't. Audiogram is borderline.
Reading is becoming impossible — the page won't stay still
A 34-year-old known to have multiple sclerosis describes the world wobbling. The eyes are never still.
Positional vertigo — but the maneuver isn't working
A 67-year-old has done two Epleys with another clinician without benefit. The positional nystagmus is purely horizontal.
The HINTS-negative stroke
A 71-year-old with acute vertigo has a normal head impulse and unidirectional nystagmus. The diagnosis is BPPV-mimic — but he can't sit up.
Conductive hearing loss without middle ear disease
A 44-year-old has a low-frequency conductive loss but a normal otoscopy and tympanogram. The Weber lateralizes to the worse-hearing side and she hears her own footsteps.