Baloh and Honrubia's Clinical Neurophysiology of the Vestibular System

Robert W. Baloh, MD, FAAN is Director of the Neuro-Ontology program in the Department of Neurology at the Reed Neurological Institute, University of California, Los Angeles in Los Angeles, CA.Kevin A. Kerber, MD, is an Assistant Professor in the Department of Neurology at the University of Michigan Health Systems. Dr. Kerber joined the UM faculty in 2005, and currently directs the Department of Neurology Dizziness Clinic. Dr. Kerber's research and clinical interests center on the presentation of dizziness, which include a number of disorders that typically involve the cerebellum, brain stem, or peripheral vestibular structures. His previous research with Dr. Baloh led to important discoveries about balance disorders in the elderly, inherited and sporadic ataxia syndromes, and oculomotor physiology. Dr. Kerber's current research focus is using health services research approaches to optimize patient care and health care utilization for dizziness presentations.

"This thoroughly updated and expanded fourth edition of Clinical Neurophysiology of the Vestibular System represents a significant contribution to the understanding of the vestibular system in health and disease. A comprehensive knowledge on the physiology and pathophysiology of the human balance system is essential for the diagnosis and treatment of patients with vestibular dysfunction. By covering all these aspects along with the clinical context,Drs. Baloh and Kerber are truly in the tradition of Robert Bárány, who founded the discipline of clinical neurotology more than hundred years ago. The clearly written text and the illustrative graphic design makethis book a valuable reference tool for physicians, clinical specialists, and researchers alike. With its meanwhile fourth edition, Clinical Neurophysiology of the Vestibular System is sure to become a classic in its field." --Gerald Wiest, MD, Department of Neurology, Medical University of Vienna, Vienna, Austria"The long-awaited revision of this well-known monograph. As before, a thorough, comprehensive clear, authoritative and now up-to-date account of the clinical neurophysiology of the vestibular system reflecting 35 years of clinical and research experience by one of the giants of modern neuro-otology. The clinical features, mechanisms, causes and treatment of all the common vestibular disorders reviewed in a practical and helpful way. An essential addition to thelibrary of any practitioner dealing with dizzy patients" --Prof, Dr G Michael Halmagyi, Neurology Department, Royal Prince Alfred Hospital, Camperdown NSW 2050, Sydney, Australia"This exciting and much-awaited new edition of "Clinical Neurophysiology of the Vestibular System" exceeds expectations. It has been prepared by authorities in the field: it is up-to-date, clear and exceptionally well written. The first chapters guide the reader through the basic principles. The following chapters deal with evaluation and treatment of common vestibular disorders and they include numerous hands-on instructions for the practitioner. This textbooktruly offers a solid and comprehensive reference base for anyone with an interest in neuro-otology." --Professor Krister Brantberg, Karolinska Hospital, Stockholm, Sweden"[This] revised third editionELis a welcome, and much-needed, resource. Updating the clinical and basic science without losing the logical coherence of this book's organization has been accomplished, and the classical underpinnings have been blended carefully with many recent changes in understandingEL.This new edition...brings up to date much of the physiology, neurology and clinical information related to the inner ear, its neurologic connections, anddisorders of balance and hearing. It fills an important gap in the understanding of these problems for neurologists and otologists alike. At a time when physicians tend to get quick answers from a brief searchof a website, this book deserves to be studied, to earn a place on the office reference shelf, and to have its knowledge incorporated into the thinking of every well-trained neurologist." --David A Drachman, MD, Professor and chairman emeritus, Department of Neurology, University of Massachusetts Medical Center, Boston, MA

• PART 1 ANATOMY AND PHYSIOLOGY OF THE VESTIBULAR SYSTEM1. OVERVIEW OF THE VESTIBULAR SYSTEM ANATOMY AND PHYSIOLOGYPERIPHERAL VESTIBULAR RECEPTORS CENTRAL VESTIBULAR PATHWAYS VESTIBULAR REFLEXESMOTION PERCEPTION AND ORIENTATIONPATHOPHYSIOLOGY OF VESTIBULAR SYMPTOMSCENTRAL COMPENSATION FOR VESTIBULAR LESIONSSUMMARY 2. THE PERIPHERAL VESTIBULAR SYSTEMTEMPORAL BONEINNER EAR (LABYRINTH)THE HAIR CELLTHE INNER EAR VESTIBULAR RECEPTORSPRIMARY VESTIBULAR NEURONSEFFERENT VESTIBULAR NEURONS 3. THE CENTRAL VESTIBULAR SYSTEMVESTIBULAR NUCLEIVESTIBULO-OCULAR REFLEXESCERVICO-OCULAR REFLEXESVISUAL-VESTIBULAR INTERACTIONVESTIBULOSPINAL REFLEXESSUBJECTIVE VESTIBULAR SENSATION 4. EPIDEMIOLOGY OF DIZZINESSSPECIFIC DISORDERSBURDEN ON PATIENTSHEALTH CARE UTILIZATIONSUMMARY PART 2 EVALUATION OF THE DIZZY PATIENT 5. THE HISTORY OF THE DIZZY PATIENTVERTIGONEAR-FAINT DIZZINESSPATHOPHYSIOLOGIC DIZZINESS (CHRONIC SUBJECTIVE DIZZINESS)DRUG-INDUCED DIZZINESSHYPOGLYCEMIADISEQUILIBRIUMOCULAR DIZZINESSMULTISENSORY DIZZINESSPHYSIOLOGIC DIZZINESSSUMMARY: DISTINGUISHING BETWEEN VESTIBULAR AND NONVESTIBULAR TYPES OF DIZZINESS 6. BEDSIDE EXAMINATION OF THE VESTIBULAR SYSTEMEXAMINATION OF THE EARTESTS OF VESTIBULOSPINAL REFLEXESTESTS OF VESTIBULO-OCULAR REFLEXESTESTS FOR PATHOLOGIC NYSTAGMUSTYPES OF PATHOLOGIC NYSTAGMUSOTHER OCULAR OSCILLATIONSOCULAR TILT REACTION 7. LABORATORY EXAMINATIONS OF THE VESTIBULAR SYSTEMNYSTAGMOGRAPHYROTATIONAL TESTING OF VESTIBULO-OCULAR REFLEXESVISUAL-VESTIBULAR INTERACTIONTESTS OF OTOLITH-OCULAR REFLEXESVESTIBULOSPINAL TESTINGVESTIBULAR-EVOKED POTENTIALS 8. CLINICAL EVALUATION OF HEARINGTYPES OF HEARING DISORDERSBEDSIDE TESTS OF HEARINGBEHAVIORAL AUDIOMETRYIMPEDANCE AUDIOMETRYTYMPANOMETRYAUDITORY-EVOKED RESPONSESGENERATING POTENTIALSTEST METHODOLOGYRESULTS IN PATIENTSCENTRAL AUDITORY SPEECH TESTSSUMMARY OF AUDITORY TEST RESULTS PART 3 DIAGNOSIS AND MANAGEMENT OF COMMON NEUROTOLOGIC DISORDERS9. INFECTIOUS DISEASESACUTE OTITIS MEDIA AND OTOMASTOIDITISCHRONIC MASTOIDITIS AND CHOLESTEATOMABACTERIAL LABYRINTHITISPETROSITISINTRACRANIAL EXTENSION OF EAR INFECTIONSMALIGNANT EXTERNAL OTITISVIRAL INFECTIONS OF THE INNER EARSYPHILITIS INFECTIONS OF THE EARTUBERCULOSIS AND MYCOTIC INFECTIONS OF THE INNER EAR 10. BENIGN POSITIONAL VERTIGOHISTORICAL BACKGROUNDCAUSES OF BPVPOSTERIOR CANAL VARIANT OF BENIGN POSITIONAL VERTIGOOTHER VARIANTS OF BENIGN POSITIONAL VERTIGO 11. ENDOLYMPHATIC HYDROPS (MENIERE'S SYNDROME)BACKGROUNDOCCURRENCECLINICAL FEATURESPATHOPHYSIOLOGYANIMAL MODELSETIOLOGYDIAGNOSISMANAGEMENT 12. MIGRAINEBACKGROUNDCLINICAL FEATURESPATHOPHYSIOLOGYDIAGNOSISMANAGEMENT 13. IMMUNE-MEDIATED DISEASESAUTOIMMUNE INNER EAR DISEASEPARANEOPLASTIC IMMUNE DISORDERSMULTIPLE SCLEROSIS 14. VASCULAR DISORDERSVERTEBROBASILAR ISCHEMIAINTRALABYRINTHINE HEMORRHAGEHEMORRHAGE INTO THE BRAIN STEM AND CEREBELLUMVASCULAR COMPRESSION SYNDROMES 15. TUMORS TUMORS OF THE MIDDLE EAR AND TEMPORAL BONE TUMORS OF THE INTERNAL AUDITORY CANAL AND CEREBELLOPONTINE ANGLE BRAIN TUMORS 16. TRAUMATRAUMA TO THE TEMPORAL BONEPERILYMPH FISTULASEMICIRCULAR CANAL DEHISCENCE SYNDROMEBRAIN TRAUMA 17. TOXIC/METABOLIC DISORDERSDIZZINESS AND SYSTEMIC METABOLIC DISORDERSMETABOLIC DISORDERS OF THE TEMPORAL BONEOTOTOXINSNEUROTOXINS 18. DEVELOPMENTAL AND GENETIC DISORDERSTHE INNER EARDISORDERS OF THE CRANIAL VERTEBRAL JUNCTIONINHERITED SPINOCEREBELLAR ATAXIA SYNDROMES PART 4 SYMPTOMATIC TREATMENT OF VERTIGO 19. ANTIEMETIC AND ANTIVERTIGO DRUGSVESTIBULAR SUPPRESSANTSANTIEMETIC DRUGSSPECIFIC DRUGS 20. VESTIBULAR REHABILITATIONADAPTIVE CONTROL OF NORMAL VESTIBULAR REFLEXESMECHANISMS FOR COMPENSATION AFTER VESTIBULAR LOSSSPECIAL CIRCUMSTANCESCONTROLLED TRIALS OF VESTIBULAR EXERCISESSTRATEGY FOR DESIGNING VESTIBULAR EXERCISESVESTIBULAR EXERCISESFUTURE DIRECTIONS APPENDIX 20-1. SAMPLE HOME EXERCISE PROGRAM 21. FUTURE DIRECTIONS Index