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Balance/Dizziness

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Having a balance and/or dizziness disturbance can be very detrimental to an individual’s way of life.  We conduct a battery of different tests to determine what is causing your balance and/or dizziness problems so that we are able to determine what can be done to correct or alleviate them. 


Signs/Symptoms

There are many different signs and symptoms of balance and/or dizziness disturbances.  These can include: drifting to one side or the other when walking, unsteadiness, falling for no reason, severe headaches, vertigo, dizziness anytime, dizziness when you turn your head a certain direction, dizziness lasting a couple seconds, minutes, or longer, nausea, vomiting, tinnitus, double vision, and many more.


Causes

There are many different factors that could be causing your balance and/or dizziness disturbances.  Some possible causes of dizziness include but not limited to:

Otologic Issues (inner ear related)
Benign Paroxysmal Positional Vertigo (BPPV)
Meniere’s Disease
Vestibular Neuritis
Labrynthitis

Central/Neurologic Issues (brain related)

Stroke
Migraine
Multiple Sclerosis
Seizure
Head trauma
                                                
Medical
Low Blood Pressure
Medications


Some possible causes of balance disturbances include but is not limited to:
Peripheral neuropathy
Migraine
Stroke
Multiple Sclerosis
Peripheral issues
Muscle Disease
Spinal Cord Disorders


Tests

There is a battery of different tests that we conduct to assess your balance and/or dizziness issues.  After we have conducted all of the necessary tests, we will pull all of the information together to determine the next course of action.  The first test conducted is a comprehensive hearing evaluation as described earlier.


Gans Sensory Organization Performance Test
is performed to determine postural stability by looking at three different sensory inputs: vision, somatosensory, and vestibular.  The patient will be asked to perform 7 different positions with their eyes open or closed.


Vestibular Evoked Myogenic Potential (VEMP) Test
looks at a couple different locations to determine if there is a lesion that is affecting the vestibulo-collic reflex pathway.  This test provides us with diagnostic information that can help diagnose a range of different causes from otologic to neurologic disorders.  Three electrodes will be placed on the patient, one on the forehead and then one on each side of the neck on the sternocleidomastoid muscle (SCM).  Insert earphones are placed in the patient’s ear and clicks are presented to one side at a time.  When the clicks begin, the patient will need to turn their head as far as they can to the opposite side that the clicks are on.  The clicks are presented for about a minute than the other side will be tested.  A couple measurements on each side will be completed.


Vestibular Autorotation Test (VAT)
is testing impairments of the vestibular-ocular reflex (VOR) which can cause balance and/or dizziness disturbances, as the VOR’s primary focus is to allow one to have clear vision when walking or moving quickly.  Electrodes are placed on the forehead and on each side of the patient’s eyes.  The patient will be required to keep their eyes focused on one spot while they move their head to beeps.  Beeps will be presented that the patient has to move their head side to side to.  The beeps will increasingly become faster, which requires the patient to move their head faster too with the beeps.  This part takes less than a minute to complete.  Then the patient will be asked to do the same thing, but instead of moving their head from side to side to the beeps, they will be asked to move their head up and down to the beeps.  Both the horizontal and vertical tests will be completed a few times in each direction.


Videonystagmography (VNG)
is the last part of the assessment.  This test involves the patient sitting in a chair with a pair of goggles on that have little cameras inside them to record the patient’s eye movements.  There will be a light bar in front of the patient with a red dot on it.  Through a series of different tests, the patient will be required to follow or look at the dot with their eyes and not move their head or body.  Then the patient’s eye movements will be recorded as they are lying in different positions (for example, lying with their head turned to the left).  The last part of the test, cool and warm air will be put into the patient’s ear canals, one side at a time.  These tests can make you dizzy, but the dizziness usually goes away after a couple minutes.  This part of the test can take about an hour to complete.


Treatment

Depending on the outcome of your test, different treatments will be recommended.  Most of the time, a physical therapy program designed for your diagnosis will be recommended.

 

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