AN APPROACH TO IMAGING THE DIZZY PATIENT

Disease of the vestibular system involves a lengthy differential diagn osis, from the relatively trivial to potentially life-threatening cond itions. As a definitive specific diagnosis is often difficult to make, imaging may be used simply to ''rule out'' serious pathology. In this context, suboptimal imaging choices may be unnecessarily expensive an d may fail to document the pathology. In contrast, an orderly investig ation includes appropriate audiometric and vestibular tests, which whe n reviewed in the clinical context, indicate the most pertinent imagin g modalities. This enables the clinician to plan a cost-effective, def initive imaging strategy. This review considers the role of imaging in an integrated approach to investigating the dizzy patient: A discussi on of vestibular pathology is presented to assist in the review, and s everal cases are provided as examples.