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Clinical Diagnosis and Management of Vestibular Disorders
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Clinical Diagnosis and Management of Vestibular Disorders

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: 25 May 2025 | Viewed by 2298

Special Issue Editors

Dr. Sinisa Maslovara

E-Mail Website
Guest Editor
Faculty of Dental Medicine and Health, University Josip Juraj Strossmayer of Osijek, Osijek, Croatia
Interests: otology; neurotology; persistent postural perceptual dizziness (PPPD); benign paroxysmal positional vertigo (BPPV); vestibular migraine; bilateral vestibulopathy; Meniere's disease
Prof. Dr. Mario Habek

E-Mail Website
Guest Editor
Department of Neurology, Referral Center for Autonomic Nervous System, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Kispaticeva, 10000 Zagreb, Croatia
Interests: neurology; multiple sclerosis
Dr. Andro Košec

E-Mail Website
Guest Editor
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sisters of Mercy, Zagreb, Croatia
Interests: otolaryngology; head and neck surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Dizziness and vertigo are one of the most common symptoms in medicine. The lifetime prevalence of vertigo in the general population in the world is high, ranging from 13–30%. The prevalence increases significantly with age, and the frequency is two to three times higher in women than in men. Vertigo is becoming a significant public health problem because it reduces people’s ability to work, leads to a decline in health-related quality of life, and can cause depression or anxiety.

The treatment of vestibular disorders can be divided according to different criteria in several ways. One of the practical/didactic divisions related to the treatment of vestibular disorders is one that talks about what the treatment affects, and it is divided into three categories: causal (specific action on a specific cause of the disease), symptomatic (treating various symptoms of the disease), and rehabilitative (aimed at promoting recovery).

This Special Issue will identify and bridge gaps in the diagnosis and management of vestibular disorders based on a combination of original research and review papers.

Topics of interest include the following:

  • The epidemiology of vestibular disorders;
  • The role of genetics in the development of vestibular disorders;
  • The assessment of the vestibular system;
  • Clinical forms of vestibular disorders;

The management of vestibular disorders.

Dr. Sinisa Maslovara
Prof. Dr. Mario Habek
Dr. Andro Košec
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • vertigo
  • dizziness
  • epidemiology
  • genetics
  • diagnostics
  • management

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Published Papers (3 papers)

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Research

11 pages, 699 KiB  
Article
Telemedicine: Inter-Method Agreement Between In-Person Consultations and Video Recordings When Diagnosing Benign Paroxysmal Positional Vertigo
by Ali A. Melliti, Rajneesh Bhandari, Anita Bhandari, Mustafa Karabulut, Ellen Rikers, Sophie Paredis, Sophie Vanbelle and Raymond van de Berg
J. Clin. Med. 2025, 14(7), 2495; https://doi.org/10.3390/jcm14072495 - 6 Apr 2025
Viewed by 387
Abstract
Objective: To investigate the inter-method agreement between in-person consultations and video recordings when diagnosing BPPV. Methods: Two experienced vestibular clinicians (clinician A and B) evaluated patients for the presence and type of BPPV, using the TRV chair (Interacoustics, Middlefart, DK), at a tertiary [...] Read more.
Objective: To investigate the inter-method agreement between in-person consultations and video recordings when diagnosing BPPV. Methods: Two experienced vestibular clinicians (clinician A and B) evaluated patients for the presence and type of BPPV, using the TRV chair (Interacoustics, Middlefart, DK), at a tertiary referral center. During these in-person consultations, diagnostic maneuvers and eye movements were recorded, and a diagnosis was made. Both clinicians independently evaluated their cases again, during two video review sessions (Video Review 1 and Video Review 2). These sessions were conducted one month apart. Both clinicians were blinded to patient information and medical history during the analysis and did not have access to sound recordings. They were asked to provide a new diagnosis, based on the videos alone. Inter-method and intra-observer agreement for BPPV diagnoses between in-person consultations and video reviews were assessed using the percentage of agreement and Cohen’s kappa. An independent analysis of all patients’ eye movements was conducted to identify patterns that might have influenced agreement between in-person consultation diagnoses and the two video reviews by clinicians. Results: During the in-person consultations, each clinician evaluated 100 patients. Clinician A diagnosed BPPV in 40% of the cases, while clinician B diagnosed it in 19% of the cases. Considering the inter-method agreement, clinician A agreed on 81% (95% CI (73, 89)) and 77% (95% CI (69, 85)) of the cases with associated kappa coefficients of 0.67 (95% CI (0.55, 0.79)) and 0.63 (95% CI (0.51, 0.75)) between in-person consultations and Video Reviews 1 and 2, respectively. For clinician B, the percentages of agreement were, respectively, 86% (95% CI (79, 93)) and 84% (95% CI (77, 91)), with corresponding kappa coefficients of 0.55 (95% CI (0.36, 0.74)) and 0.51 (95% CI (0.32, 0.70)). As for the intra-observer agreement, clinician A achieved an intra-observer agreement of 84% (95% CI (77, 91)) with kappa = 0.74 (95% CI (0.63, 0.85)), while clinician B achieved a slightly higher intra-observer agreement of 90% (95% CI (84, 96)) with kappa = 0.67 (95% CI (0.51, 0.83)). Descriptive analysis of the eye movement revealed that both clinicians showed high diagnostic consistency for “no BPPV” in cases without provoked nystagmus (78/86, 91%) even when spontaneous nystagmus was present, and for posterior canal BPPV (37/78, 47%) when characteristic nystagmus was observed. However, disagreement was noted for horizontal canal BPPV (15 cases) and in scenarios with subjective BPPV (2 cases) or purely vertical nystagmus (11/31 cases, 35%). Conclusions: This study showed the feasibility of using video recordings when diagnosing BPPV. It demonstrates that BPPV might be reliably diagnosed in a telemedicine setting. However, careful consideration must be given to certain factors during the protocol’s design to improve the diagnostic process. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management of Vestibular Disorders)
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12 pages, 800 KiB  
Article
A Comparison of cVEMP and VNG Examination Results Between Adults and Children with a History of Vertigo
by Anna Waśniewska-Włodarczyk, Oskar Rosiak, Renata Pepaś, Filip Wróbel and Wiesław Konopka
J. Clin. Med. 2025, 14(7), 2222; https://doi.org/10.3390/jcm14072222 - 25 Mar 2025
Viewed by 220
Abstract
Background/Objectives: Dizziness and vertigo are common symptoms. Vertigo, caused by vestibular deficit, is usually diagnosed with videonystagmography (VNG) and cervical vestibular evoked myogenic potential (cVEMP). Normative values of these examinations have been established for adults; however, the impact of age is still uncertain. [...] Read more.
Background/Objectives: Dizziness and vertigo are common symptoms. Vertigo, caused by vestibular deficit, is usually diagnosed with videonystagmography (VNG) and cervical vestibular evoked myogenic potential (cVEMP). Normative values of these examinations have been established for adults; however, the impact of age is still uncertain. This study aimed to compare the results of VNG and cVEMP between adults and children. Methods: We analyzed and compared the results of VNG and cVEMP in 119 patients (35 adults and 84 children.) Results: Statistically significant differences were observed between adults and children in the amplitude of the cVEMP examination. In the subgroup analysis by age, we also noticed differences in VNG examination in nystagmus induced by rotation in patients with peripheral vertigo and in IFO (index fixation test) and VOR (vestibulo-ocular reflex) in patients with non-peripheral vertigo. Conclusions: This study confirms that there are differences in vestibular examination results between children and adults. However, the exact impact of age on each part of the vestibular examination requires further investigation. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management of Vestibular Disorders)
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14 pages, 1316 KiB  
Article
Graviception Uncertainty, Spatial Anxiety, and Derealization in Patients with Persistent Postural-Perceptual Dizziness
by Kathrine Jáuregui-Renaud, Rodrigo Cabrera-Pereyra, José Adán Miguel-Puga and Mónica Alcántara-Thome
J. Clin. Med. 2024, 13(22), 6665; https://doi.org/10.3390/jcm13226665 - 6 Nov 2024
Viewed by 963
Abstract
Objectives: Persistent Postural-Perceptual Dizziness (PPPD) is a frequent diagnosis in patients with chronic dizziness, ineffective postural control, visual dependence, and emotional symptoms. Methods: 53 patients with PPPD (25–84 years old) and 53 adults (29–84 years old) with no vestibular disease agreed [...] Read more.
Objectives: Persistent Postural-Perceptual Dizziness (PPPD) is a frequent diagnosis in patients with chronic dizziness, ineffective postural control, visual dependence, and emotional symptoms. Methods: 53 patients with PPPD (25–84 years old) and 53 adults (29–84 years old) with no vestibular disease agreed to participate in this study. Assessments included: vestibular function tests (sinusoidal yaw rotation and vestibular-evoked myogenic potentials); accuracy and precision of Subjective Visual Vertical (SVV) estimation while static and during on-axis yaw rotation; static posturography with open/closed eyes and 30° neck extension, while standing on hard/soft surface; questionnaires on symptoms of unsteadiness, spatial anxiety, dizziness-related handicap, anxiety/depression, depersonalization/derealization, and perceived stress. After preliminary bivariate analyses, analysis of covariance was performed on the measurements of postural sway, spatial anxiety, and dizziness-related handicap (p < 0.05). Results: Higher intraindividual variability (reduced precision) on SVV estimations was evident in patients with PPPD compared to adults with no vestibular disease, which was related to the length of postural sway, to velocity displacement in the sagittal plane, as well as to spatial anxiety and common mental symptoms (including depersonalization/derealization symptoms). Covariance analysis showed contribution of these factors to the dizziness-related handicap reported by the patients. Conclusions: Unprecise graviception could be a contributing factor to the postural instability and mental symptoms reported by patients with PPPD, which in turn contribute to their dizziness-related handicap. Full article
(This article belongs to the Special Issue Clinical Diagnosis and Management of Vestibular Disorders)
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