This book has been written by Peter Weber and a number of co-authors who have contributed chapters, with the aim of providing a better understanding of patients presenting with vertigo and disequilibrium. It is aimed at a range of medical professionals with ‘an interest in vestibular disorders’.
The chapters have been arranged in a slightly odd way, in that the chapter on ‘clinical anatomy and physiology’ comes after the chapters on ‘computerized vestibular testing’ and ‘radiology for vertigo and disequilibrium’. I think it would have been more sensible to present knowledge on the anatomy and physiology of this area before these other two chapters. The chapter on formal vestibular assessment seems to cover its topic well, but I could not see any obvious indications, which would be of value in a book which is meant to be a ‘practical guide’. The chapter on radiology seems to be a review of the radiology of the temporal bone, and does not really give any insights from the main author's years of experience in dealing with patients with vertigo.
There are a number of chapters on a variety of common peripheral vestibular disorders, which are well covered, especially with respect to benign paroxysmal positional vertigo. This latter chapter goes into great detail on positional vertigo of the posterior semicircular canal and other canals, along with a variety of treatments that have been successfully used by doctors to treat their patients. There are a number of pictures illustrating the Epley manoeuvre, amongst other manoeuvres. However, the person performing this procedure pointedly looks away from the patient in every picture, which seems more than a little bizarre as it is important to look at the patient's eyes during the procedure in order to confirm the diagnosis and for purposes of reassurance. Other chapters cover Ménière's disease and labyrinthitis.
Some chapters have been dedicated to central nervous system disorders causing vertigo, while others deal with rare causes of this symptom. There are also separate chapters on ‘congenital vestibular disorders’ and ‘blood tests’. I am left slightly confused as to why these last two have been included, as they do not seem to offer any help as a ‘practical guide’. The last chapter of the book covers ‘vestibular rehabilitation’ and is particularly well written and helpful.
The book also comes with a DVD which shows the eye movements during various components of a vestibular assessment. Other abnormal eye movements are also shown, covering a range of diagnoses both common and rare. This is a particularly good aspect of this book, as it is often difficult to describe the peculiarities of particular eye movements – ‘once seen, never forgotten’.
Overall, this book does offer a significant amount of detail for the common peripheral vestibular pathologies presenting with vertigo, which was one of the author's main aims:
If a physician can master diagnosing BPPV, vestibular neuronitis and Ménière's disease, then he or she can diagnose 80 per cent of all vestibular complaints.
The book would have been helped by some colour, along with summary points for each chapter. I am not sure that it amounts to a ‘practical guide’ or a definitive text on this subject. I personally found it quite hard to read, but it will prove useful as a reference book, especially when dealing with patients with odd positioning nystagmus, or when one cannot quite remember how to do the ‘Guffoni manoeuvre’!
