Clinical cases
Eight clinical scenarios drawn from the disease chapters. Each case presents a vignette, an audiogram, and a six-canal vHIT trace; you choose the most likely diagnosis and the simulator reveals the teaching point.
trainee · Case
Case 1 — Sudden vertigo, no hearing loss
A 38-year-old man wakes with severe spinning vertigo, vomiting, and unsteadiness.
clinician · Case
Case 2 — Vertical canal-only deficit
A 51-year-old woman has 36 hours of moderate vertigo with nausea but is now able to walk with mild unsteadiness.
trainee · Case
Case 3 — Episodic vertigo with fluctuating hearing loss
A 47-year-old woman has had six episodes over the past year of spinning vertigo lasting 2 to 5 hours, accompanied by right-sided aural fullness, low-pitched tinnitus, and reduced hearing in the right ear.
foundation · Case
Case 4 — Brief positional vertigo, normal vHIT
A 59-year-old woman reports 5 days of brief spinning vertigo whenever she rolls to the right in bed or looks up.
clinician · Case
Case 5 — Slowly progressive unilateral hearing loss with mild unsteadiness
A 56-year-old man reports three years of slowly progressive left-sided hearing loss with intermittent left-sided tinnitus.
trainee · Case
Case 6 — Oscillopsia and falls in the dark
A 68-year-old retired engineer describes two years of progressively worse unsteadiness, three falls in the past year (all on uneven ground or in dim light), and 'bouncing' of his visual field when he walks briskly or drives over rough roads.
clinician · Case
Case 7 — Vestibular neuritis... or stroke?
A 71-year-old man with hypertension, type 2 diabetes, and prior smoking presents with 4 hours of severe continuous vertigo, nausea, and unsteadiness.
trainee · Case
Case 8 — Slowly worsening unsteadiness in a CF patient
A 41-year-old woman with cystic fibrosis has had multiple intravenous tobramycin courses (estimated total dose over 15 years: ~300 g) for pulmonary exacerbations.