Case 15 · foundation

Bouncing vision while walking after IV antibiotics

Vignette

A 60-year-old man finished a 4-week course of intravenous gentamicin two months ago for endocarditis. He now reports that signs at the railway station 'bounce' as he walks, and he cannot read his phone in a moving car. He has no rotational vertigo. Examination: head impulse test is positive in both directions with bilateral corrective saccades. Bucket SVV is 0.0° with a normal SD. Caloric responses are bilaterally absent.

SVV trace

+0.0° ± 1.0°

Symmetrically absent input gives a normal SVV

Why is the SVV normal in a patient with profound vestibular failure?

Continuous vertigo for two days with no hearing lossAll cases
Subjective Visual Vertical

An interactive teaching atlas of Subjective Visual Vertical for the assessment of otolith-graviceptive function — bucket and digital technique, dynamic SVV, normal findings, and the tilt signatures of peripheral and central vestibular disease. Content synthesised from current Bárány Society criteria, peer-reviewed vestibular literature, and standard otoneurology texts.

→ Full references & acknowledgements
Built for

Medical students, ENT / Neurology / Audiology trainees, vestibular therapists, and clinicians who want to teach themselves the language of vertigo.

Concept & design
Dr Prahlada N.B

Karnataka ENT Hospital and Research Centre (R),
Champions Educational and Medical Society (R),
Amogh Foundation, Chitradurga, Karnataka, India

Please share your valuable feedback to:
prahladnb@kenthospitals.com

Disclaimer

For educational purposes only. Not for clinical use. The Subjective Visual Vertical chapter is an instructional resource intended to support learning about SVV and the assessment of otolith-graviceptive function. Clinicians remain completely responsible for the interpretation of findings, the formulation of a differential diagnosis, and any clinical decision. Nothing in this application replaces individualized assessment, hands-on training, expert consultation, or established practice guidelines.

© 2026 Dr Prahlada N.B · Karnataka ENT Hospital and Research Centre (R) · Champions Educational and Medical Society (R) · Amogh Foundation, Chitradurga, Karnataka, India
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