Let's Talk Vestibular Closing Fireside Chat

Overview

Dizziness is one of the most common, and most complex, presentations in clinical practice. Differential diagnosis is rarely straightforward, and the path from assessment to effective treatment requires integrating vestibular, neurological, cardiovascular, and psychosocial frameworks into a coherent clinical picture. This closing session of the Let's Talk Vestibular series brings together four expert clinicians: Kregg Ochitwa, Carolyn Vandyken, Jules Poulin, and Sonia Vovan, for an in-depth, conversational fireside chat that synthesizes the core themes of the full series.

Rather than a formal lecture, this session is a candid clinical conversation: real questions, genuine disagreements, and practical wisdom drawn from decades of combined experience across physiotherapy, massage therapy, pain science, and vestibular rehabilitation. Viewers will leave with a stronger conceptual framework for approaching dizzy patients — and a clearer sense of when to treat, when to refer, and when to look beyond the inner ear.

Learning Objectives

By the end of this course, you will be able to:

1. Apply a biopsychosocial framework to the differential diagnosis of dizziness, integrating vestibular, neurological, cardiovascular, and psychosocial contributing factors.
2. Describe the clinical utility and limitations of the HINTS exam in distinguishing peripheral vestibular dysfunction from posterior stroke in acute vestibular syndrome presentations.
3. Explain the role of TMJ dysfunction as a co-factor in dizziness and identify when cervicogenic or TMJ-related contributions warrant interdisciplinary referral.
4. Recognize post-concussion dizziness as a functional sensory-motor integration disorder that may not present with identifiable structural lesions on imaging.
5. Conduct a thorough, time-efficient vestibular history using structured screening approaches to guide clinical reasoning and therapeutic alliance.
6. Identify clinical red flags and referral indicators that require escalation to otolaryngology, neurology, audiology, or other specialists.
7. Reflect on the limitations of a purely biomedical approach to vestibular care, particularly in cases where no identifiable organic cause is found.

Audience

This course is designed for physiotherapists, physical therapists, massage therapists, and other allied health professionals who assess or treat patients with dizziness, balance disorders, or vestibular dysfunction. It is particularly well-suited to clinicians who attended one or more sessions of the Let's Talk Vestibular series and want to consolidate their learning through an integrative, expert-level discussion.

Practitioners new to vestibular rehabilitation will benefit from the clinical reasoning frameworks and assessment principles presented throughout. More experienced vestibular clinicians will find value in the nuanced discussion of biopsychosocial drivers, diagnostic complexity, and interdisciplinary collaboration, areas that are rarely covered with this level of depth and candour in traditional continuing education.

Why This Course Matters

Up to 80% of dizziness presentations have no clearly identifiable organic cause, yet clinical training often defaults to a biomedical model that assumes a structural lesion at the root of every symptom. For practitioners managing dizzy patients, this mismatch between training and clinical reality creates a gap: thorough tests come back normal, standard protocols don't apply, and patients leave without answers. This course addresses that gap directly.

The fireside chat format surfaces something formal lectures rarely do: the messiness of real clinical reasoning. Panelists disagree on nuance, share cases that didn't follow the textbook, and articulate the clinical thinking behind decisions that protocols can't fully capture. For practitioners who have felt underprepared when a dizzy patient doesn't fit a clean vestibular diagnosis, this session offers both a conceptual reframe and concrete clinical tools including the HINTS exam, structured history-taking frameworks, and biopsychosocial screening approaches.

Vestibular rehabilitation is increasingly recognized as a field that demands interdisciplinary fluency. A cervicogenic component, a TMJ co-factor, a concussion history, or an anxious nervous system can each complicate, or mimic, a classic vestibular presentation. This course helps practitioners hold all of that complexity, know when to dig deeper, and know when to refer.