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January 2015Assessing dizziness is a diagnostic challenge. There are multiple possible etiologies for dizziness—some rooted in the anatomy and physiology of the inner ear, some not—and until recently, clinician assessment of dizziness and the vestibular system was limited by a lack of diagnostic tools.
For nearly a century, the assessment of the vestibular system was been restricted to assessment of the semicircular canals. The caloric test assesses lateral semicircular canal function. Bedside head impulse testing (HIT) can assess the function of the vertical semicircular canals, but the test is not always easy to perform or interpret; bedside HIT relies on clinicians’ subjective evaluation of saccade. The otolith organs have largely been ignored because there was no way to assess them.