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Managing balance patients poses a challenge for many clinicians. Vestibular disorders affect a large part of the population and hence present to various specialties including ENT, audiology, neurology and primary care. The healthcare cost of balance disorders and any resultant falls and fragility fractures is very high.

Similarly, the personal cost of unresolved balance symptoms is increased morbidity with a negative impact on activities of daily living, resulting in a loss of independence and consequent reduced quality of life. Up to 80% of fallers admitted to A&E in the UK had symptoms of an underlying vestibular impairment. A prompt, accurate diagnosis and management of the instability of patients with vestibular deficits would therefore reduce associated morbidity and healthcare expenditure.

This concise manual would be useful for trainees and established clinicians who are trying to get to grips with a myriad of vestibular pathology, assessments and their interpretation to guide management strategies, be it for an examination or for day-to-day clinical practice. There is the good balance of theoretical information with practical advice on conducting tests and interpretation of results. The book is written in the hybrid style of a manual and a notebook with bullet points and tables. There are some useful illustrations with a very brief reference list at the end. There is a small risk that it falls through a gap between knowledge and practice.

Overall this book is short, succinct and practical which will make it easier to understand and handle for busy clinicians.

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Jaydip Ray (Prof)

PhD, MS, FRCS, Sheffield Teaching Hospitals NHS Foundation Trust, UK.

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