Dizziness Evaluation / Vestibular & Balance Function Test

When a person suffers from dizziness, a dizziness evaluation, also called a vestibular & balance function test can determine if illness or damage to the vestibular portion of the inner ear is the cause of the dizziness. Some of the evaluations that are often included are:

  • Electronystagmogram (EMG): tests the cooperation between eye movements, vision and the inner ear function using electrodes attached to the face.
  • Videonystagmography: is similar to the EMG, but uses infrared goggles to measure eye movements.
  • Posturography: tests postural control and the sensory, motor, and central processes to diagnose vestibular and neuromuscular disorders contributing to dizziness. These evaluations are carried out while the patient is standing.

Vestibular System & Balance

Your vestibular system includes organs, nerves, and structures that reside in your inner ear. Simply put, it is your body’s main center of balance. The vestibular system works together with your proprioceptive system (touch & body awareness), eyes, and brain.

Videonystagmography

Anatomically, balance begins in the inner ear. Aside from hearing, Audiologists are experts in vestibular disorders that can cause vertigo, dizziness, and loss of balance. A VNG, or videonystagmography test battery, is an exam to measure an involuntary eye movement called nystagmus.

During a VNG test, you will sit in a dark room and wear special medical goggles. These goggles have a camera that records eye movements. The test battery consists of 3 main parts:

  • Ocular Testing: You will be instructed to follow both moving and stationary dots on a light bar.
  • Positional Testing: Your provider will move your head and body in different positions. Your provider, alongside the recording from your goggles, will check whether these movements cause nystagmus
  • Caloric Testing: Usually the final part of the test battery, where warm and cool water will be inserted into each ear canal. In general, the eyes should flicker away from the cold temperature side and back, and towards the warm temperature side and back. If the eyes deviate from this outcome, this may mean there is some damage in the inner ear. Your Audiologist will compare results between ears, in order to determine whether one ear is damaged as opposed to both or neither.

Your Audiologist can prepare a detailed report that you can review with an ENT doctor, who will further interpret & explain the results to you.

Vestibular Rehabilitation

Audiologists, alongside ENT doctors and Neurologists, are experts in helping patients rehabilitate from vestibular disorders such as BPPV or Meniere’s Disease. Audiologists and their assistants can teach you gaze stabilization exercises to improve gaze and posture stability, perform canalith repositioning maneuvers, and alongside ENT doctors, treat labyrinthitis and vestibular neuritis.

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