Clinical cases
Eight hand-authored vignettes covering the most common patterns you will see in clinic. Each case ends with a single-best-answer question and a teaching point linked back to the relevant chapter.
Two-year history of oscillopsia after gentamicin
A 58-year-old man treated with intravenous gentamicin for endocarditis 18 months ago reports difficulty reading street signs while walking and a sensation of the world bouncing.
Sudden vertigo, three days ago
A 35-year-old woman presents 72 hours after sudden-onset spinning vertigo with vomiting.
Episodic vertigo with fluctuating hearing loss
A 47-year-old woman has had 7 episodes over the past year of spinning vertigo lasting 30–90 minutes, with low-frequency fluctuating hearing loss and aural fullness on the right.
Asymmetric high-frequency hearing loss
A 52-year-old man with two years of progressive right-sided tinnitus and high-frequency hearing loss has an MRI showing a 12 mm intracanalicular vestibular schwannoma on the right.
Sound-induced dizziness and autophony
A 38-year-old singer reports dizziness with loud sounds and hearing her own footsteps and heartbeat in the right ear.
Persistent vertigo and double vision
A 64-year-old woman has 6 weeks of unsteadiness, episodic diplopia and downbeat nystagmus.
Translabyrinthine schwannoma resection nine months ago
A 60-year-old man who underwent a left translabyrinthine resection nine months ago reports near-normal function.
Mild unsteadiness, age 72
A 72-year-old woman has mild unsteadiness without falls.