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vestibular examination is essential whenever we are faced with a patient with vertiginous syndrome.
It involves making the patient wear special glasses (Frenzel glasses), dimly lit, or alternatively by a more sophisticated video oculoscopia-infrared (see fig. Bottom right). In this way the movements are evaluated eye is involuntary (such as nystagmus) and volunteers (such as tracking movements slow and fast ones).
The examination is carried out on a couch with her legs out first and then making the patient assume different positions (lying on the right side and left with his head out of bed etc...)

vestibular examination is a useful tool to identify the cause of vertigo, and many times, if the cause is represented by the detachment of small pebbles in the ear, called otoliths, are made of maneuvers designed to reposition the otoliths, with the final disappearance of symptoms vertiginosa(vedi il video sotto).

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Benign Paroxysmal Positional Vertigo vestibular neuritis

Una delle cause più frequenti di vertigini è sicuramente la vertigine parossistica posizionale benigna . Essa si presenta come una vertigine che insorge prevalentemente a letto o quando ci si rialza , oppure quando ci si abbassa come per allacciarsi le scarpe o ancora quando si guarda in alto.
E' una vertigine tipicamente oggettiva(ossia si ha la sensazione che l'ambiente ci giri intorno), insorge in maniera brusca ed ha una durata di pochi secondi o minuti (in genere meno di un minuto). Tale sintomatologia è spesso accompagnata da nausea, vomiting, sweating , etc pale skin.
The cause is due to detachment of small stones, called otoliths, that moving the liquid in the inner ear are capable of generating labyrinthine vertigo.

therapy in these cases is to perform the appropriate maneuvers on a bed or designed to reposition the otoliths

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The vestibular neuritis is the 2nd cause frequent sudden objective vertigo.
It is due to an inflammation of the vestibular nerve the cause of which was the result of an infection viral or insufficient vascular supply labyrinthine.
It comes with a sudden intense vertigo, often roundabout, accompanied by nausea and vomiting, which forces the patient to stay in bed for hours or days.
The diagnosis is based on: anamnesis story, unidirectional spontaneous nystagmus, otoscopy and audiometric tests negative . The
must be established as soon as possible steroid therapy with excellent results after just the first few hours after treatment and rehabilitation should be started the .
With proper treatment, 50% of patients recover completely after 3 months, 75% after 6 months.