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Balance Function
Assessment and Management
Third Edition
Editor-in-Chief for Audiology
Brad A. Stach, PhD
Balance Function
Assessment and Management
Third Edition
Gary P. Jacobson, PhD
Neil T. Shepard, PhD
Kamran Barin, PhD
Robert F. Burkard, PhD
Kristen Janky, AuD, PhD
Devin L. McCaslin, PhD
5521 Ruffin Road
https://t.me/medicina_free
San Diego, CA 92123
e-mail: information@pluralpublishing.com
Website: https://www.pluralpublishing.com
Copyright © 2021 by Plural Publishing, Inc.
Typeset in 10/12 Palatino by Flanagan’s Publishing Services, Inc.
Printed in the United States of America by Integrated Books International
All rights, including that of translation, reserved. No part of this publication may be reproduced, stored in a
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including photocopying, recording, taping, Web distribution, or information storage and retrieval systems
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For permission to use material from this text, contact us by
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Disclaimer: Please note that ancillary content (such as documents, audio, and video, etc.) may not be
included as published in the original print version of this book.
Library of Congress Cataloging-in-Publication Data
Names: Jacobson, Gary P., editor. | Shepard, Neil T., editor. | Barin,
Kamran, editor. | Burkard, Robert F., 1953- editor. | Janky, Kristen,
editor. | McCaslin, Devin L. (Devin Lochlan), editor.
Title: Balance function assessment and management / [edited by] Gary P.
Jacobson, Neil T. Shepard, Kamran Barin, Robert F. Burkard, Kristen
Janky, Devin L. McCaslin.
Description: Third edition. | San Diego, CA: Plural Publishing, [2021] |
Includes bibliographical references and index.
Identifiers: LCCN 2019035307 | ISBN 9781635501889 (hardcover) | ISBN
1635501881 (hardcover) | ISBN 9781635501995 (ebook)
Subjects: MESH: Vestibular Diseases — diagnosis | Vestibular
Diseases — therapy | Vestibular Function Tests — methods | Vertigo |
Dizziness
Classification: LCC RF260 | NLM WV 255 | DDC 617.8/82 — dc23
LC record available at https://lccn.loc.gov/2019035307
Contents
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Preface ix
About the Editors xi
Contributors xiii
1 An Historical Perspective of the Perception of Vertigo, Dizziness, and 1
Vestibular Medicine
Christopher K. Zalewski
2 Ontogeny of the Vestibular System and Balance 15
Timothy A. Jones and Sherri M. Jones
3 Practical Anatomy and Physiology of the Ocular Motor System 43
Scott D. Z. Eggers
4 Practical Anatomy and Physiology of the Vestibular System 69
Jamie M. Bogle and Robert F. Burkard
5 Practical Biomechanics and Physiology of Balance 87
Lewis M. Nashner
6 Clinical Neurophysiology of Vestibular Compensation 105
Kamran Barin
7 The Vertigo Case History 125
Jay A. Gantz, Belinda C. Sinks, and Joel A. Goebel
8 Assessing Dizziness-Related Quality of Life 143
Erin G. Piker, Gary P. Jacobson, and Craig W. Newman
9 Bedside Assessment of the Vestibular System 167
Carrie W. Hoppes, Karen H. Lambert, and Devin L. McCaslin
10 Eye Movement Recording and Ocular Motility Testing 189
Neil T. Shepard, Michael C. Schubert, and Scott D. Z. Eggers
11 Positional Testing and Treatment 225
Richard A. Clendaniel
12 Caloric Testing 257
Kamran Barin
v
vi BAlAnCE FunCtion AssEssmEnt And mAnAgEmEnt
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13 Rotational Vestibular Assessment 283
Christopher K. Zalewski
14 The Video Head Impulse Test (vHIT) 333
Ian S. Curthoys, Hamish G. MacDougall, Leigh A. McGarvie, Konrad P. Weber,
David Szmulewicz, Leonardo Manzari, Ann M. Burgess, and G. Michael Halmagyi
15 Computerized Dynamic Posturography: Methodology and Interpretations 365
Lewis M. Nashner and Neil T. Shepard
16 Vestibular-Evoked Myogenic Potentials (VEMPs) 399
Devin L. McCaslin and Gary P. Jacobson
17 Electrocochleography (ECochG) 439
Paul R. Kileny and Devin L. McCaslin
18 Pediatric Vestibular Testing 457
Kristen Janky and Neil T. Shepard
19 Vestibular Balance Therapy for Children 479
Jennifer B. Christy
20 Medical Management of Vertigo That Is Otologic in Origin 489
Brian Neff and R. Mark Wiet
21 Surgical Management of Vertigo That Is Otologic in Origin 501
R. Mark Wiet
22 Neurologic Origins of Dizziness and Vertigo 519
Joseph M. Furman and Susan L. Whitney
23 Behavioral Factors in Dizziness and Vertigo 529
Jeffrey P. Staab
24 Vestibular Rehabilitation 549
Susan L. Whitney and Joseph M. Furman
25 The Aging Vestibular System: Implications for Rehabilitation 577
Dara Meldrum and Courtney D. Hall
26 Topographical Localization of Vestibular System Impairment 597
Gary P. Jacobson, Erin G. Piker, Richard A. Roberts,
Devin L. McCaslin, and Nabih M. Ramadan
27 Challenging Cases 617
Neil T. Shepard
Appendix I Pathophysiology Signs and Symptoms of Dizziness 629
Neil T. Shepard
ContEnts vii
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Appendix II Coding and Billing 645
Robert F. Burkard, Neil T. Shepard, and Stuart Trembath
Appendix III Interprofessional Education and Practice 653
Neil T. Shepard and Robert F. Burkard
Appendix IV Specialty Rotational Vestibular Assessments 659
Christopher K. Zalewski
Index 689
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PrefaCe
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On behalf of the editors and authors, we would like
to welcome you to the third edition of Balance Func-
tion Assessment and Management. Notable updates to
this edition include the first chapter that reviews “An
Historical Perspective of the Perception of Vertigo
and Dizziness and Vestibular Medicine.” We have
also included new chapters on the topics of “Vestibular Balance Therapy for Children” (Chapter 19) and
“The Aging Vestibular System: Implications for Rehabilitation” (Chapter 25). Further, this edition includes
a chapter on “Challenging Cases” (Chapter 27) and
we end this textbook with four appendices covering
“Pathophysiological Signs and Symptoms of Dizziness,” “Coding and Billing,” “Interprofessional Education and Practice,” and “Specialty Rotational Vestibular
Assessments.” In response to the comments from read-
ers of the second edition, we have reduced the length
of the textbook by making it more concise.
Finally, the reader will note that this third edition
has been edited by six nationally and internationally
known clinical scientists in the area of dizziness, vertigo, and chronic unsteadiness. . These editors include
Kamran Barin, PhD, Robert F. Burkard, PhD, Kristen
Janky, AuD, PhD, and Devin L. McCaslin, PhD. We are
grateful for the participation of these talented individuals in the planning, development, and realization of
this third edition. It has been our objective from the first
edition of Balance Function Assessment and Management
to produce a textbook for both the student and the practitioner that treats comprehensively the assessment and
management of dizziness. To the extent that we have
achieved this goal, you, the reader, will be the judge.
Gary P. Jacobson, PhD Neil T. Shepard, PhD
ix
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