Four Ways to Be Dizzy: When Physiology Fails to Explain Disability Insights From the UVIS International Survey

The aim of this international study is to better understand how vestibular disorders affect daily life, including physical balance, vision and movement tolerance, emotional wellbeing, and cognitive functioning. Vestibular disorders are common but often difficult to diagnose because symptoms vary widely from one patient to another. To improve clinical care, we need large-scale information on the real-world experience of patients across different countries and clinical settings. The UCLouvain Vertigo International Survey (UVIS) collects standardized information from adults with confirmed vestibular disorders, including questionnaires about dizziness-related handicap, emotional symptoms, and cognitive-vestibular complaints. Ear-nose-throat (ENT) specialists also provide routine clinical test results, such as caloric testing, vestibular evoked myogenic potentials (cVEMP and oVEMP), video head impulse tests (vHIT), and posturography. By combining these data, the study aims to identify different patient profiles and to examine how subjective symptoms relate to the physiological function of the vestibular system. Participants take part during their routine clinical visit. They complete short questionnaires (on dizziness, anxiety, depression, cognitive symptoms, and daily functioning), and their ENT specialist encodes the results of the vestibular tests already performed as part of their usual care. No additional medical tests are required for the study. By comparing data from several centers in Belgium, France, and the United States, this project seeks to provide a more complete picture of vestibular disorders worldwide and to support the development of better diagnostic tools and more personalized rehabilitation strategies.