Amol Anand, Audiovestibular Medicine Speciality Registrar
The British Society of Neuro-Otology Conference 2025 brought a wonderful sense of excitement to Governors Hall at St Thomas’ Hospital in November. Hosted by the Multidisciplinary Balance Team in ENT at Guy’s Hospital, the meeting showcased the breadth of neuro otology, a field dedicated to understanding balance disorders and the vestibular system.
This year, 180 delegates travelled from across the world, bringing together neurologists, ENT surgeons, audiovestibular physicians, audiologists, physiotherapists, psychologists and neuroscientists. The involvement of Ménière’s and Vestibular UK, who also sponsored the event, added a valued patient-centred voice.
The opening day, focused on balance in Parkinson’s disease, proved highly engaging. A central theme was whether dizziness in Parkinson’s reflects true vestibular dysfunction or a broader multisensory integration difficulty, explored by Prof Aasef Shaikh, Nicolaas Bohnen and Prof Adolfo Bronstein. Prof Bastiaan Bloem delivered an insightful session on gait disturbance and falls, highlighting subtle clinical signs crucial to understanding instability. Emerging technology featured strongly, with Prof Chrystalina Antoniades presenting work on digital gait markers, wearable sensors and oculomotor measurements that may allow earlier detection of balance changes. 
The psychological dimension of imbalance in Parkinson’s disease was also addressed. Will Young presented qualitative work capturing the lived experience of freezing of gait, while Prof Mark Carpenter showed how anxiety and fear of falling can intensify vestibular and postural responses.
The second day honoured the career of Prof Adolfo Bronstein and reflected the deep appreciation for his influence on modern neuro otology. Speakers from across the world contributed to the celebration, each highlighting different areas of progress in the field he helped shape. Among the notable presentations, Prof David Zee traced the history of cerebellar eye movement control; Prof Ji Soo Kim shared clinical insights into vascular vertigo; and Prof Antonio Lopez Escamez outlined developments in the genetics of Ménière’s disease. Prof Jeffrey Staab’s lecture on visual dependence in PPPD resonated widely across clinical disciplines. Adding further depth, Prof Michael Halmagyi explored caloric-impulsive test dissociation, explaining that it is not specific to Ménière’s disease and discussing possible mechanisms behind this intriguing finding. 
The final day showcased emerging research from students, trainees and academics. Sessions covered smartphone eye-tracking, spaceflight vestibular adaptation, functional dizziness and new theoretical models of chronic dizziness. Delegates praised the vibrant programme, the supportive atmosphere and the unforgettable riverside setting — briefly brightened by sunshine in the Millennium Garden before Friday’s storm arrived.
