Most UK readers of a certain age will fondly remember the phrase ‘and now for something completely different’. That was indeed my immediate impression when we reviewed the first edition of this book in 2013. In the plethora of new textbooks in our specialty, someone had had the inspiration to notice a huge gap and a largely neglected topic in training.

This new addition comes with much more than a colour change in the cover and a fuller image of the entire labyrinth. We now have a new author added, pages have expanded from 365 to 458, and there are no fewer than five new chapters, and two fully rewritten chapters covering migraine and concussion. Some chapters carry references to articles published as recently as 2019, showing commendable updating.

Now this can be complex stuff and it is obviously a highly specialised topic, but it is equally applicable to paediatricians and neurologists as it is to us. Dentato-rubro-pallido-luysian atrophy does not roll off the tongue, but there it sits amongst neurodegenerative disorders.

The chapters are divided into four sections. Essentially these are the basic sciences, clinical investigation, vestibular disease processes and treatment. Each chapter features nicely set out text with many a boxed heading, allowing for easy reading and browsing. Monochrome illustrations are plentiful and well reproduced. Each chapter carries case studies and self-assessment questions, which I confess I did find ‘challenging’. I was puzzled on page 302 to be assured that acoustic neuroma is a common peripheral cause of vertigo, but the questions are generally well thought out and a very useful feature.

A new chapter on video head impulse testing (‘vHIT’) explains its particular value in children, although we may yet have to learn to call it ‘SHIMP’ (do not ask). Any chapter title starting ‘New Horizons’ was bound to prove welcome. The chapter on genetics and metabolism looked daunting at first glance, and it certainly was ‘comprehensive’, but it actually proved to be written in a very comprehensible style, with headings such as ‘When to suspect’ and ‘Family history interpretation’. Benign paroxysmal positional vertigo now has its own chapter, but particularly impressive was Chapter 24 entitled ‘Vertigo, Dizziness and Mental Health’, which I thought the star of the new content.

This is a very well updated and expanded revision of what was a very important book at its first publication. Paediatric balance disorders represent a neglected topic in our training, and one suspects this topic would appear more in higher examinations if only the examiners felt more confident in this field.