Diagnostic Vestibular Pocket Guide: Evaluation of Dizziness, Vertigo, and Imbalance

First Edition

Julie A. Honaker

Details: 288 pages, B&W, Softcover, 4.5" x 8"

ISBN13: 978-1-63550-312-8

© 2021 | Available


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Diagnostic Vestibular Pocket Guide: Evaluation of Dizziness, Vertigo, and Imbalance is a “lab coat pocket guide” for clinicians and students who evaluate patients with balance disorders. This quick reference condenses all facets of the clinical evaluation to provide guidance in a range of situations, including appointment preparation, vestibular screening measures, and appropriate objective testing. Specific chapters target common disorders and evaluation, required modifications based on age, forming clinical impressions, and medical referral criteria.

Key Features

  • Succinct explanations of vestibular principles and test procedures
  • Compact and portable design for frequent use
  • Concise and approachable outline format for quick reference
  • Tabs for each chapter, a list of common abbreviations, and index ensures easy access to during an appointment
  • 80 figures and tables 
  • Appendix outlining key symptoms, signs, and management options for peripheral, central, and systemic conditions 


"As per the title, this is a paperback, easy reference, guide which, for once, will actually fit in many a pocket. It is ideally suited to a 'dipping in' or browsing approach, rather than reading from cover to cover at one sitting. The format, with boxed highlighted text, many an algorithm, table or line diagram and its clinical applicability does immediately appeal.

The content is conventional, with coverage of the basic sciences, clinical evaluation and the interpretation of the many objective tests of vestibular function now widely available, whether a rotatory chair or ice water in the ear canal! I would single out for praise the chapter on history taking (especially 'Building up Rapport and Setting up the Visit Agenda') or that on 'Basic' clinical examination in the office setting. These two chapters alone commend the book to any trainee in otology or neurology. You would expect, and sure enough get, coverage of the most sophisticated objective testing such as electronystagmography, the rotational chair, the video head impulse test and vestibular evoked myogenic potentials. The applicability, methodology and interpretation of each is described in an understandable fashion, and that is no easy feat. [...]

A particularly well thought out chapter emphasises how the entire clinical approach is modified according to the patient’s age, whether in childhood or advanced 'maturity'.

The book closes with an Appendix which tabulates the symptom characteristics, clinical signs, pathophysiology and management options for a series of disorders. It is notable that this is supported by a list of references almost exclusively post 2015. This is a well updated book throughout.

This is not the easiest subject to master, but this is a very good introduction and it is ideally suited to repeated reference by the novice."

—Liam M. Flood, FRCS, FRCSI, in Journal of Laryngology & Otology (January 2021)

“…I was impressed with the volume and depth of knowledge Julie could pack in this pocket guide. The text is full of well-presented tables with the most up-to-date and relevant data from the literature. I purposefully looked for details in several of the chapters and could find all of them explained clearly and concisely. For instance, different hand placements and testing techniques, according to the manufacturer of your vHIT goggles, are described and well-illustrated. 
In fact, the visual is yet another positive aspect of this book. Figures and pictures are strategically utilized. I particularly liked the clean look of all the drawings designed for the BPPV chapter.
'Chapter 10 – Vestibular Care Path and Modifications to Standard Procedures Based on Patient Age' is a welcome reflection for the Vestibular Audiologist. It invites the clinician to mindfully select the most appropriate and relevant testing protocol, taking age and clinical presentation into consideration, rather than sticking with a predetermined test battery applied mechanically to everyone. 
Similarly, 'Chapter 11. Report Writing and Medical Referral Guide' brings the Vestibular Audiologist back to reflect on their role in diagnosing and managing vestibular disorders. It calls on the fact that obtaining test results is only one part of the puzzle for the individual in front of you and that your responsibility is far greater than stating those numbers on your report.”

–Erica Zaia, MSc, University of British Columbia, in the Canadian Audiologist (March 2022)



Chapter 1. Vestibular Principles and Pathways Review
Chapter 2. Appointment Preparation and Case History
Chapter 3. Office Vestibular ‘Bedside’ Examination
Chapter 4. Benign Paroxysmal Positional Vertigo (BPPV) Diagnosis and Treatment
Chapter 5. Electronystagmography (ENG)/Videonystagmography (VNG)
Chapter 6. Rotational Chair Test (RCT) 
Chapter 7. Video Head Impulse Test (VHIT) 
Chapter 8. Vestibular Evoked Myogenic Potentials (VEMPs)
Chapter 9. Computerized Dynamic Posturography (CDP) 
Chapter 10. Vestibular Care Path and Modifications to Standard Procedures Based on Patient Age
Chapter 11. Report Writing and Medical Referral Guide 

Appendix A
Appendix B
Common Abbreviations


Julie A. Honaker

Julie A. Honaker, PhD, CCC-A, is the Director of the Vestibular and Balance Disorders Program at the Cleveland Clinic. Her passion for vestibular sciences developed during her master’s program in audiology and PhD at the University of Cincinnati, followed by a post-doctoral fellowship at the Mayo Clinic.  Before joining the Cleveland Clinic, she was an Associate Professor at the University of Nebraska-Lincoln where her teaching and research program focused on vestibular and balance sciences. As an audiologist, she strives to advance the care of patients with balance disorders and, most importantly, she mentors students to become independent and critical thinkers and consumers and producers of research. She engages in clinical research and clinical training for Neurology and Ear, Nose, and Throat residents and Doctor of Audiology Externs.

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