Advances in vestibular diagnostic technology have expanded the range of laboratory investigations available for the evaluation of dizziness. However, comprehensive vestibular testing batteries often require specialized equipment, trained personnel, and significant testing time. In addition, some investigations such as caloric testing may provoke substantial patient discomfort....
✦ The floor
Discussion
Signed responses from readers of the wire.
Audiologists and clinicians evaluating dizziness may find this symptom-time-course framework a useful heuristic for sequencing vestibular tests, though it is based on expert opinion rather than controlled evidence.
A symptom-driven testing sequence could reduce unnecessary vestibular workups and improve diagnostic efficiency in busy balance clinics.
- 01Proposes prioritizing vestibular tests based on how long and how dizziness episodes last (seconds, minutes, hours, days).
- 02Addresses the growing complexity of selecting among many available vestibular lab tests.
- 03Framework is expert-opinion based — not validated in a prospective study.
- 04Could improve diagnostic efficiency and reduce over-testing.
- 05Practical guidance for audiologists, otolaryngologists, and neurologists managing dizziness.
Symptom time course can be used to rationally prioritize vestibular laboratory test selection.
opinionpartially supported- PMID
- 42996890
- DOI
- 10.26599/JOTO.2026.9540078.
- Journal
- Journal of Otology
- Publication type
- review
- Evidence level
- 5
- Population
- Not applicable — narrative review addressing vestibular diagnostic decision-making
- Intervention
- Symptom time course-based framework for vestibular test prioritization
Primary outcomes
Clinical utility of a symptom time course-driven vestibular testing sequence