Thursday, November 10, 2016

Robert W. Baloh's "Vertigo"

Robert W. Baloh, MD is a professor of Neurology and Head and Neck Surgery at UCLA who has written more than 300 research articles and several textbooks focusing on the vestibular system. His interest in the history of Neurotology dates back to a series of conversations with Raphael Lorente de Nó in the early 1970s.

Baloh applied the “Page 99 Test” to his new book, Vertigo: Five Physician Scientists and the Quest for a Cure, and reported the following:
This book tells the story of the search for, and discovery of, a simple cure for vertigo, that strange sense of spinning, when you’re really not. In the process I provide a historical approach to understanding the vestibular system – the parts of the inner ear involved in balance and equilibrium and their connections within the brain.

Benign paroxysmal positional vertigo (BPPV) is by far the most common cause of vertigo. Sudden violent spells of vertigo are triggered by a change in position such as turning over in bed, getting in and out of bed, bending down and straightening up, and extending the head back to look up. As I delved into the history of the discovery of a simple bedside cure for BPPV, I became intrigued with the individuals who made the major contributions. In many ways, the story is a microcosm of the development of medical science over the past century and a half. The road to the discovery of a cure for BPPV involved investigators from around the world and was strewn with missed opportunities, serendipitous findings and academic intrigue.

On page 99 of my book I illustrate the Romberg and past-pointing tests used by Robert Bárány to measure vestibular function in patients. Bárány, the first to clearly describe BPPV, had a brilliant early career working in the clinic of the pioneer otologist Adam Politzer at the University of Vienna. He was awarded the Nobel Prize for Medicine for his work on the inner ear in 1914 but his colleagues at the University of Vienna suggested that his ideas were not original and that he had plagiarized others in his writings. As circumstances became intolerable in Vienna, Bárány moved to Uppsala, Sweden where he spent the rest of his career in relative isolation.

I have been in a unique position to obtain information about the key investigators described in the book. I’ve worked on and written about the vestibular system for more than 40 years and have been collecting historical data including detailed interviews with family members and colleagues. I have had access to numerous historical documents that have not previously been translated into English.
Learn more about Vertigo at the Oxford University Press website.

--Marshal Zeringue