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Updated: Jul 19, 2025

Perspectives on Neuroscience
Published on: July 31, 2007
Neurological update: neuro-otology 2023
Gábor M Halmágyi1,2, Gülden Akdal3,4, Miriam S Welgampola5,6
1Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia. gmh@icn.usyd.edu.au.
Abstract:
Much has changed since our last review of recent advances in neuro-otology 7 years ago. Unfortunately there are still not many practising neuro-otologists, so that most patients with vestibular problems need, in the first instance, to be evaluated and treated by neurologists whose special expertise is not neuro-otology. The areas we consider here are mostly those that almost any neurologist should be able to start managing: acute spontaneous vertigo in the Emergency Room-is it vestibular neuritis or posterior circulation stroke; recurrent spontaneous vertigo in the office-is it vestibular migraine or Meniere's disease and the most common vestibular problem of all-benign positional vertigo. Finally we consider the future: long-term vestibular monitoring and the impact of machine learning on vestibular diagnosis.
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