What is useful in vestibular testing?

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The possible causes of vertigo and dizziness are multiple, the symptoms are nonspecific, and some typical features of a particular syndrome may be absent for a long period of time. In addition, the case history may be confusing as it often includes somatic as well as psychological elements. Moreover, all generally used diagnostic tests are severely limited. Facing these difficulties, the clinician has two options. The first is to systematically perform an extensive otoneurological workup including audiological, vestibular and radiological tests. In this case, he risks to perform unnecessary examinations, or to have difficulties in interpreting inconsistent results, which reflect the limitations of the diagnostic tests. On the other hand, the clinician may choose to limit the investigation to the minimum, risking to miss information indispensable to the diagnosis.