Quick reference
One screen. Every disease signature, the SVV pattern, and a one-line bedside pearl.
Normal
Normal- Direction
- —
- Magnitude
- 0–2°
- Variability
- ±1°
- OTR
- absent
Upper limit of normal: ±2°. Mean and SD both within range.
Vestibular neuritis (acute)
Peripheral- Direction
- Ipsilesional
- Magnitude
- 5–10°
- Variability
- ±1°
- OTR
- incomplete
+HIT on the same side. Tilt decays over weeks.
Vestibular neuritis (chronic)
Peripheral- Direction
- Often resolved
- Magnitude
- 0–3°
- Variability
- ±1°
- OTR
- absent
Static SVV compensates by ~3 months. Dynamic SVV unmasks residuals.
Inferior-division neuritis
Peripheral- Direction
- —
- Magnitude
- 0–2°
- Variability
- ±1°
- OTR
- absent
Normal SVV. cVEMP is the test that catches it.
Wallenberg syndrome
Central- Direction
- Ipsilesional
- Magnitude
- 8–15°
- Variability
- ±1°
- OTR
- complete
Large tilt + normal HIT = posterior circulation stroke until proven otherwise.
INC / rostral midbrain lesion
Central- Direction
- Contralesional
- Magnitude
- 5–10°
- Variability
- ±1°
- OTR
- complete
Above the decussation. The only common contraversive OTR.
Ménière's (active attack)
Peripheral- Direction
- Ipsilesional
- Magnitude
- 3–6°
- Variability
- ±1–2°
- OTR
- incomplete
Direction stable across attacks; magnitude varies with activity.
Ménière's (between attacks)
Peripheral- Direction
- Often resolved
- Magnitude
- 0–3°
- Variability
- ±1°
- OTR
- absent
Often normal; serial SVV tracks utricular involvement.
Vestibular schwannoma
Peripheral- Direction
- Ipsilesional (variable)
- Magnitude
- 1–4°
- Variability
- ±1°
- OTR
- absent
Slow growth → static SVV compensates. Use dynamic SVV.
Superior canal dehiscence
Third window- Direction
- Variable
- Magnitude
- 0–2°
- Variability
- ±1°
- OTR
- absent
Normal SVV + augmented oVEMP with lowered threshold = textbook SCD.
BPPV (any canal)
Canal disorder- Direction
- —
- Magnitude
- 0–2°
- Variability
- ±1°
- OTR
- absent
Canal disorder; otoliths intact. Abnormal SVV = additional pathology.
Cerebellar (nodulus/uvula)
Central- Direction
- Variable
- Magnitude
- 0–3°
- Variability
- ±3–5°
- OTR
- absent
Variability is the diagnosis. Mean alone misses it.
Vestibular migraine (ictal)
Central- Direction
- Variable across attacks
- Magnitude
- 0–4°
- Variability
- ±1–2°
- OTR
- absent
Inconsistent direction across attacks separates from Ménière's.
PPPD
Functional- Direction
- —
- Magnitude
- 0–2°
- Variability
- ±1°
- OTR
- absent
Normal SVV is required by the diagnostic criteria.
Pusher syndrome (visual SVV)
Central- Direction
- —
- Magnitude
- 0–2°
- Variability
- ±1°
- OTR
- absent
Visual SVV near-normal; postural vertical grossly tilted. Test both.
Bilateral vestibulopathy
Peripheral- Direction
- —
- Magnitude
- 0–2°
- Variability
- ±1°
- OTR
- absent
No asymmetry → normal SVV despite profound impairment. Use HIT and DVA.
Magnitude ranges and directions are illustrative, drawn from peer-reviewed series. Real measurements vary with chronicity, dominant nerve division, age, and method.