Vertigo and dizziness are one of the most common complaints of patients consulting a doctor. These symptoms can be very disturbing to the patient, but a precise diagnosis is often di cult to make and, in many instances, satisfying therapy is lacking. The diagnostic approach has to be multidisciplinary including otolaryngology, ophthalmology and neurology. In November 1996 an international conference on 'Therapy of ocular motility and related visual disturbances' was held at Case Western Reserve University, Cleveland, Ohio, and was organized by H.]. Kaminiski and R.J Leigh [conference summary see, Neurology 1997;48:1178-1184]. At this conference it became quite clear that impressive progress has been made on the basic neurophysiological and neuropharmacological mechanisms of ocular motility over the last 10 years, and has resulted in a number of successful therapeutical studies. However, it was also obvious that more research and clinical studies are required. Particularly in the field of drug therapy, the number of patients investigated in double-blind controlled studies is still very small.
Over the last years the basic mechanisms of benign paroxysmal positioning vertigo (BPPV), one of the most common causes of vertigo, have successfully been worked out. The correct application of these findings to physical therapy has led to impressive, often astonishing results. With a single maneuver lasting less than 5 min patients who had su ered from vertigo for many years can often be cured.