Currently viewing Vol. 4 • Issue 3 • 2017

Vertigo and Disequilibrium: A Practical Guide to Diagnosis and Management, 2nd Edition by Peter C. Weber

Thieme Medical Publishers, Inc., 2017 ISBN 978-1-62623-204-4

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book coverThe second edition of this book by Peter C. Weber aims to “demystify the vestibular system and vestibular disorders”. This book does an excellent job of providing a predominantly general overview to all things vestibular without going into too much technical detail, making it a good resource for many different health professions: medicine, otolaryngology, audiology and physical therapy, just to name a few. Included with this book is electronic access to twenty-four videos through Thieme’s MediaCenter to augment what you are reading.

In addition to the videos, I can greatly appreciate some of the “interactive” portions of this book. For example, six of the chapters in this book have clinically-based review questions at the end of the chapter with an answer key, making this a good resource for educators. The appendix also has a section on frequently asked questions with answers on various topics within the vestibular system – this is a great source of information for clinicians first starting out in their practice.

One of the best features of this book is the section on radiological studies of the vestibular patient (Chapter 4). This section includes high-resolution imaging examples using typical modalities such as computed tomography and magnetic resonance imaging, but also includes more specialized modalities such as magnetic resonance angiography, magnetic resonance venography, and digital subtraction angiography. The amount of imaging for different disorders and the detail that this section goes into is unlike anything I have seen in other vestibular textbooks.

The reader will appreciate the latest information on surgically implantable vestibular devices (Chapter 21). This section covers relevant anatomy, physiology, potential candidacy, and the design and function of vestibular implants. It also nicely covers the history of vestibular implant prototypes and information about clinical trials with vestibular implants at the time of publication. This is a topic that is not commonly covered in other vestibular textbooks.

This book covers topics on pediatric vestibular disorders (Chapter 15) and how the vestibular system changes in older adults (Chapter 14), making this a good resource for the vestibular system over the lifespan. This book covers the “mainstream” or common vestibular disorders, but also delves into some of the more obscure topics: Mal de debarquement syndrome and allergy and autonomic dizziness, just to name a few. There is also a nice summary of vertigo of central etiology (Chapter 18) and a dedicated chapter for vestibular migraine (Chapter 16) which is often overlooked in vestibular assessment and management.

As a vestibular audiologist, I really like that this book contains information relevant to many different professions working with the vestibular system and the dizzy patient. The more detailed information about radiological studies, surgical interventions, and medications in how they relate to the vestibular patient, is good information for audiologists to know to help us work inter-professionally. Not all entry-level audiology programs allow for sufficient time to be spent on the teaching of vestibular assessment and management; this book offers a good foundation for someone who is just starting to work with vestibular patients. Individuals looking for more specific technical information (e.g., how to perform each of the sub-tests of a videonystagmography) will need to look to other clinical textbooks for that information, but this book certainly meets the author’s aim to demystify the vestibular system and its related disorders.

Book Chapters

  • Taking the History of the Vertiginous Patient
  • Office Examination of the Vestibular Patient
  • Computerized Testing of the Vestibular Patient
  • Radiological Studies for the Vestibular Patient
  • Surgical Anatomy and Physiology of the Vestibular Patient
  • Laboratory Testing in the Diagnosis and Treatment of Dizziness
  • Meziere’s Disease
  • Benign Paroxysmal Positional Vertigo
  • The Pathology and Treatment of Benign Paroxysmal Positional Vertigo
  • Labyrinthitis
  • Superior Semicircular Canal Dehiscence Syndrome
  • Autoimmune Vestibular Dysfunction, Perilymph Fistulas, Mal de Debarquement Syndrome, and Alcohol-Related Dizziness
  • Allergy and Autonomic Dizziness
  • Aging: Balance and Vestibular Disorders
  • Congenital and Pediatric Vestibular Disorders
  • Migraines As a Source of Vestibular Disorders: Diagnosis and Management
  • Rare Causes of Unilateral Peripheral Vestibulopathy
  • Central Vertigo and Disequilibrium
  • Medications Used in Treating Acute and Chronic Vertigo and Various Vestibular Disorders
  • Vestibular Rehabilitation
  • Implantable Vestibular Devices
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About the author

Michael Vekasi, AuD, R.Aud, Aud(C), FAAA

Dr. Vekasi is a Senior Trainer for Allied Health with a province-wide clinical information system implementation at Alberta Health Services. He was previously a clinical audiologist where his caseload focused on vestibular diagnostic assessments as well as a multi-disciplinary vestibular clinic. He is an Adjunct Assistant Professor with A.T. Still University, teaching vestibular assessment and management to post-professional Doctor of Audiology students, and a sessional instructor at MacEwan University.

He is an editor of the “Striking the Right Balance” column in Canadian Audiologist, an executive member of the National Vestibular Special Interest Group, a director (and president-elect) for the Canadian Academy of Audiology (CAA) and also volunteers his time with ACSLPA, SAC, the AAofA (Alberta Association of Audiologists), and TAP (The Audiology Project) Canada.

Dr. Vekasi was recipient of the Queen Elizabeth II Platinum Jubilee medal in 2022 and awarded the 2020 Professional Leadership Award from A.T. Still University.