1 Vestibular Principles and Pathways Review SENSORY MODALITIES OF BALANCE CONTROL The balance system coordinates compensatory eye, head, and body movements allowing for clear vision with head and body activities,…

5 Electronystagmography (ENG)/Videonystagmography (VNG) OVERVIEW Electronystagmography (ENG)/videonystagmography (VNG) utilizes two-dimensional (2D) eye movement recordings to indirectly examine the following: (1) peripheral vestibular function (e.g., low frequency horizontal semicircular canals (SCCs)…

9 Computerized Dynamic Posturography (CDP) OVERVIEW The human postural control system is uniquely designed to maintain the center of gravity (COG) over a small base of support (BOS) by integrating…

6 Rotational Chair Test (RCT) OVERVIEW The rotational chair test (RCT) is a natural and repeatable multi-frequency stimulation of the vestibuloocular reflex (VOR; Barin, 2009). Specifically, the RCT is a…

7 Video Head Impulse Test (VHIT) OVERVIEW The concept of head impulse testing (HIT) was introduced in 1988 as a bedside measure of semicircular canal (SCC) paresis (Halmagyi & Curthoys,…

8 Vestibular Evoked Myogenic Potentials (VEMP) OVERVIEW Bickford, Jacobson, & Cody (1964) first recorded a sound-induced potential from an electrode placed at the inion, which was modulated with neck electromyography…

11 Report Writing and Medical Referral Guide OVERVIEW Components of the medical report should outline the overall justification of medical necessity and skilled services used to render diagnosis. The American…

10 Vestibular Care Path and Modifications to Standard Procedures Based on Patient Age REVIEW Selection of vestibular services should reflect justification of medical necessity to render diagnosis and treatment planning…

3 Office Vestibular “Bedside” Examination OVERVIEW Proper identification of causes for symptoms of dizziness, vertigo, and imbalance includes both thorough case history and office vestibular “bedside” examination. The bedside examination…

2 Appointment Preparation and Case History OVERVIEW Obtaining case history in the dizziness clinic, whether in-person or via remote (telemedicine), is of diagnostic importance. There is a fine balance between…