Technological Advances in Testing the Dizzy Patient: The Bedside Examination Is Still the Key to Successful Diagnosis

When evaluating patients with dizziness, knowledge of basic vestibular physiology and bedside examination techniques is critical to reach the correct diagnosis. During the vestibular examination, the clinician should look for signs of static and dynamic vestibular imbalance in the semicircular canal and otolith function. Here we outline the key components of the clinical vestibular examination considering recent technical advances in video-oculography and mobile devices such as tablet computers. Using these portable technologies, the vestibular examination can be quantified at the bedside to improve diagnostic accuracy and clinical management. In this process, a careful and thorough clinical evaluation of all subtypes of eye movements, stance, and gait is critical because of the close anatomic and physiologic connections among vestibular, postural, and ocular motor functions.