Abstract
Introduction
The evaluation of the patient with vertigo or other sensations of disturbed spacial orientation can be a difficult and perplexing task. But if these complaints are accompanied by changes in auditory function, the differential diagnosis of the disorder is usually made easier for the clinician. Therefore, a careful and systematic analysis of threshold and suprathreshold auditory functions should be a part of the clinical examination of every ‘dizzy’ patient, but it has not been the custom in Queen Square to perform a large number of tests, but to make sure that a few well-tried ones are meticulously carried out. Thus tests of auditory discrimination of complex signals such as speech, detection of the presence of recruitment, alongside pure tone air and bone conduction with adequate masking, are necessary, but the use of over-elaborate audiological testing schemes in clinical practice does much to discredit neuro-otology.
The problem of central deafness is, as yet, often difficult to understan. Small lesions may be associated with noticeable deafness whilst in patients with very large areas of pathology there may be no appreciable
The tests of hearing which are of value in neur-otological diagnosis are described and the results obtained with the tests of hearing loss associated with lesion at different levels in the nervous system: cortical, sub-cortical, mid-brain, auditory nerve and in nar ear.