Jorge Madrigal Duval
Dr. Jorge Madrigal is a vestibular physician and medical educator based in Mexico City, Mexico. He is the founder and director of La Academia del Vértigo, a leading initiative in Latin America focused on the structured training of physicians in the diagnosis and management of vestibular disorders. With over 20 years of clinical experience, Dr. Madrigal has played a pivotal role in building educational pathways that address the knowledge gap in neuro-otology across Spanish-speaking countries.
Through La Academia del Vértigo, he has developed a multidisciplinary and international network that has trained professionals in more than 13 countries. His educational approach emphasizes clinical reasoning, adherence to international diagnostic criteria (such as those of the Bárány Society), and the practical application of evidence-based protocols. In collaboration with other regional leaders, he has helped to translate and disseminate core reference materials, including the official Spanish version of the Bárány Society Vestibular Medicine Curriculum.
Dr. Madrigal is an active member of the Bárány Society, the leading international organization dedicated to the study and advancement of vestibular science. His involvement in the Society reflects his commitment to global standards and continuous exchange with the international community of vestibular specialists.
He is also committed to integrating digital innovation in medical education. He actively develops content for online learning platforms and social media, and uses structured data systems to improve clinical documentation and patient outcomes in vestibular care.
His main areas of research include:
Persistent Postural-Perceptual Dizziness (PPPD): with a focus on clinical presentation, differential diagnosis, and long-term management strategies.
Benign Paroxysmal Positional Vertigo (BPPV): particularly in cases where it coexists with other vestibular syndromes or central disorders.
Vestibular migraine and tinnitus: investigating the clinical overlap between auditory and vestibular symptoms to improve diagnostic clarity.
Access to care in underserved populations: evaluating scalable solutions to train frontline providers and reduce diagnostic delays.
He regularly participates as a speaker in national and international conferences and is involved in collaborative publications aimed at improving standards in vestibular medicine education and practice.
Session
Persistent Postural-Perceptual Dizziness (PPPD) is a relatively common, yet under-recognized, functional vestibular disorder that often leaves clinicians and patients equally perplexed. Defined by chronic dizziness, non-spinning vertigo, and subjective unsteadiness lasting at least three months, PPPD is typically triggered by an acute vestibular insult—such as vestibular neuritis, BPPV, or a panic attack—and sustained by altered postural control, visual dependence, and hypervigilance.
PPPD presents a unique challenge to otolaryngologists, as vestibular testing is frequently normal, and traditional peripheral vestibular diagnoses do not fully explain the patient’s symptoms. Without clear physical findings, both diagnosis and explanation become difficult, often resulting in over-testing, patient frustration, and delayed treatment. For these reasons, clinicians need structured, practical tools to confidently diagnose PPPD, communicate the condition in a compassionate and understandable way, and offer evidence-based treatment options.
This keynote lecture will provide a comprehensive overview of PPPD tailored specifically for otolaryngologists. Attendees will gain a deep understanding of the neurophysiological and psychogenic mechanisms behind the condition, learn to identify it based on the Bárány Society’s diagnostic criteria, and explore real-world communication strategies to help patients make sense of their symptoms. Special attention will be given to explaining PPPD without pathologizing psychological comorbidities, such as anxiety or panic, which are often present and misunderstood.
In addition, the presentation will cover updated treatment approaches, including the role of SSRIs and SNRIs, which are not typically within the scope of ENT pharmacology, as well as cognitive behavioral therapy and vestibular rehabilitation. Guidance will be offered on building a multidisciplinary network for collaborative care, especially when referrals to mental health professionals or physiotherapists are indicated.
Key topics include:
Understanding PPPD’s functional pathophysiology
How to explain PPPD to the patient
Treatment algorithms combining medication, cognitive behavioral therapy, and vestibular rehab effectively
Multidisciplinary coordination
Outcome Objectives:
To improve participants’ clinical understanding of the pathophysiology and features of PPPD.
To provide ENT clinicians with diagnostic confidence based on international guidelines.
To offer practical, patient-centered communication strategies that support therapeutic engagement.
To present up-to-date, evidence-based treatment options and promote interdisciplinary management.
Background: Although officially defined in 2017, PPPD remains underdiagnosed due to its complex presentation and the absence of abnormalities on routine testing. This can lead to chronic patient distress, repeated consultations, and ineffective treatments. Otolaryngologists are in a pivotal position to intervene early by recognizing the condition, providing a meaningful explanation, and guiding patients toward effective, integrated care. This lecture will bridge the gap between scientific knowledge and ENT clinical practice to improve outcomes for patients with persistent dizziness.