Neurological update: neuro-otology 2023

J Neurol. 2023 Dec;270(12):6170-6192. doi: 10.1007/s00415-023-11922-9. Epub 2023 Aug 17.

Abstract

Much has changed since our last review of recent advances in neuro-otology 7 years ago. Unfortunately there are still not many practising neuro-otologists, so that most patients with vestibular problems need, in the first instance, to be evaluated and treated by neurologists whose special expertise is not neuro-otology. The areas we consider here are mostly those that almost any neurologist should be able to start managing: acute spontaneous vertigo in the Emergency Room-is it vestibular neuritis or posterior circulation stroke; recurrent spontaneous vertigo in the office-is it vestibular migraine or Meniere's disease and the most common vestibular problem of all-benign positional vertigo. Finally we consider the future: long-term vestibular monitoring and the impact of machine learning on vestibular diagnosis.

Keywords: Head impulse test; Meniere’s disease; Positional vertigo; Vestibular event monitoring; Vestibular machine learning; Vestibular migraine.

MeSH terms

  • Benign Paroxysmal Positional Vertigo / diagnosis
  • Dizziness
  • Humans
  • Meniere Disease* / diagnosis
  • Neurotology*
  • Vestibular Diseases* / diagnosis
  • Vestibular Diseases* / therapy
  • Vestibular Neuronitis* / diagnosis
  • Vestibular Neuronitis* / therapy