Do you experience dizziness, vertigo or balance problems?
There are several causes of vertigo, dizziness or balance disorders. The exact cause of your specific condition can only be determined as part of an extensive evaluation. Although vertigo and dizziness are generally caused by the ear, nerves or central disorder. Other causes include medical disorders, infections, anaemia, diabetes mellitus, psychiatric disorders or drugs.
To maintain postural balance, the proprioceptive, vestibular, and visual systems continuously provide body position and movement data to the central nervous system.
The peripheral vestibular system, also known as the labyrinth, comprises the inner ear’s semicircular canals and otolith organs. These structures detect motion and gravity, sending signals to the central vestibular system in the brainstem and cerebellum via the vestibular nerve.
The central vestibular system processes these signals to help maintain balance, posture, and spatial orientation. Connections in the brainstem and cerebellum help integrate information from the vestibular organs with visual and proprioceptive cues.
The vestibulo-ocular reflex is a neurological mechanism that helps maintain stable vision during head movements. When the head rotates, signals from the vestibular system in the inner ear are sent to the eye muscles to coordinate movement, allowing the eyes to remain focused on a target.
Which uses sensory receptors in muscles and joints to provide information about body position and movement
You’ve been referred to an audiologist for vestibular testing because your symptoms- usually dizziness, vertigo or balance issues- may be related to an issue in your inner ear This visit will determine whether a problem in the inner ear is the source of your symptoms. This will guide your healthcare team toward the best treatment options for you.
Many patients are anxious about their first audiologist appointment. You may already be feeling ill from your symptoms, and you might be fearful about participating in activities that worsen them. However, the anticipation of the appointment is often the worst part. While a few of the tests may bring on some of your symptoms, this will typically not last long.
The Audiologist who conducts this testing work with many dizzy patients and are experts at helping them through the process. Also, always remember: even if you have some dizziness, these important tests will bring you one step closer to a diagnosis and a treatment plan. This will help you feel better as soon as possible.
The testing is approximately 3-4 hours. We conduct an extensive evaluation possibly consulting with several professionals. Additional members of the team usually include an ear nose and throat (ENT) specialist and/or a neurologist. The assessment may leave you feeling slightly dizzy or off-balance, so it’s a good idea to arrange for someone else to drive you home afterwards.
We utilize the latest diagnostic equipment and advanced hearing aid technology to provide you with precise and effective solutions tailored to your hearing needs.
It is important to adhere to certain instructions before having an VNG test, this will be provided to you as soon as you make an appointment.
You will sit comfortably and let your tester know when you hear soft beeps. Your hearing organ (cochlea) and vestibular organ are closely related and rely on the same nerve. Your hearing status may provide important information about how your vestibular organ is doing
Videonystagmography (VNG) is a series of eye-movement tests that look for signs of vestibular dysfunction or neurological problems by measuring nystagmus (a type of involuntary eye movement). VNG tests are the most common ones administered to people with dizziness, vertigo, and/or balance disorders. During a VNG the patient wears goggles in which infrared video cameras are mounted. The first part of the test involves doing simple eye movement tasks
Warm and cool water or water will be gently placed in your ear canal while your provider measures movements of your eyes. The water stimulates the balance organ in each ear separately, which can be very important in determining how best to manage your symptoms. Many patients can sense that their balance system is being stimulated during this test and report feeling “swimmy” or “spinny.” However, most people tolerate this testing just fine.
You will be placed in different positions to see if they affect the movements of your eyes or how you feel. You will wear special goggles with cameras inside for this. Your provider may also move your head in a few different ways to measure how your vestibular system responds.
Electrophysiological testing: small sensors (electrodes) will be placed on various spots on your head and neck, and measurements will be taken to see how your inner ear responds. These tests usually don’t require much work on your part. In some cases, you may be asked to lift your head up to tighten your neck muscles.
(vHIT) The video head impulse test (vHIT) is an ear-specific test that detects disorders of the vestibuloocular reflex (the reflex connecting your eyes to your balance system) and identifies which ear and specifically which semi-circular canals have been affected by a balance disorder. During the vHIT test, the patient wears lightweight goggles with an infrared video camera and the audiologist stimulated the semi-circular canals with small quick head movements.
Some causes of dizziness, such as BPPV, may be able to be treated immediately at the time of your testing. Your provider will be able to tell you if you have signs of BPPV. Usually, your healthcare provider will not be able to give you all of your results on the day of the test. She will send a report to the provider who referred you for testing.
So what ARE the next steps?
What happens next depends on the testing that was performed and the results of your assessment.
Normal results
If your results are normal you may be referred for consultation with experts in other specialties (e.g. neurology, cardiology, ENT).
Sometimes, just a few of the tests described above will be performed at your first appointment (e.g. hearing test, VNG, calorics). If the results of these tests are normal but your provider still suspects you have a vestibular disorder, specialized testing may be recommended to further investigate and test your vestibular system.
Alternatively, if your results indicate you do not have a vestibular disorder, you may be referred for testing with other specialties. A wide range of medical conditions can cause dizziness, and it is important to discover the cause of your symptoms to find treatment that will help you. The good news is that vestibular testing may help point you in the right direction, even if you don’t have a vestibular disorder. Certain patterns of results can help narrow down the possible cause of your dizziness and guide you to the appropriate specialist.
Treatment options will depend on which disorder is affecting you. Treatment options may include manoeuvres, vestibular rehabilitation, physical therapy, lifestyle modifications, dietary changes and/or medical treatment. Surgery is rarely prescribed for vestibular disorders.