Dizziness and balance issues are a major health concern for patients of all ages; an estimated one in three people experience these problems at least once in their lifetime. Each year, dizziness and imbalance result in five to eight million visits to physician’s offices, and about a third of those are caused by a vestibular disorder. For patients experiencing dizziness or imbalance, the first step is identifying the cause of the symptoms. Once your condition is assessed and diagnosed, a Louisville vestibular expert at Heuser Hearing Clinic will explain the best treatment options available.
Dizziness & Balance Tests
At Heuser Hearing Clinic in Louisville, vestibular testing procedures are available for patients of all ages. Our assessment procedures ensure we provide each patient with an accurate diagnosis in order to determine the right treatment plan. In most cases, you can expect to undergo a physical examination along with several different tests. These tests accurately assess whether your balance problems are associated with the inner ear. If the inner ear isn’t determined to be causing your dizziness or imbalance, your doctor may recommend further diagnostic testing such as an MRI scan to determine if the problem is neurological or is caused by another underlying condition.
Your doctor will use your medical history and the results of diagnostic tests to rule out causes of your dizziness and vertigo. Once other serious medical causes have been excluded, an audiologist can help. Audiologists specialize in the diagnosis and treatment of vestibular problems and can perform special tests to determine the cause and assess whether treatment is needed.
A complete vestibular assessment takes approximately two hours. The test is painless but you may feel dizzy or nauseated for some time after the appointment. Because of this. we recommend that you arrange for someone to drive you home from after your visit.
Types of Vestibular Tests
Tests to determine the cause or source of dizziness may include a standard hearing test battery in addition to specialized balance tests, electronystagmography, rotational tests, electrocochleography, and more.
An audiometric evaluation is often critical to determine the type and location of the vestibular problem, regardless of the presence or absence of hearing loss. The hearing and balance systems share a common location as well as nerve position and fluids, so hearing or ear problems can often provide good information concerning dizziness and imbalance.
Electronystagmography (ENG) and Videonystagmography (VNG)
ENG and VNG tests evaluate the function of the vestibular or balance portion of the inner ear. Eye movements are measured while the inner ear is stimulated, either with electrodes in the case of ENG testing or a camera in the case of VNG testing. Heuser Hearing Clinic’s vestibular experts may stimulate movement by requesting eye movement, head movement or body position changes; they may also introduce cool and warm air into the inner ear.
Balance Function Tests
A balance function exam includes a series of progressive balance challenges to determine the functional relationship, as well as its effect on balance, between vision, the somatosensory system (skin, joints, and muscles) and the vestibular system.
This type of testing evaluates how well the inner ear and central nervous system function in response to rotational stimulation. Depending on the patient, we may use different strategies and the stimulation may be either active or passive. The most common type of rotational test is the rotary chair test.
Auditory Brainstem Response (ABR)
This test provides information about the electrical activity in the auditory pathway between the inner ear and the brain, and measures a person’s hearing sensitivity. ABR is commonly used for patients who have not previously completed another site of lesion test such as a CT scan or MRI.
An electrocochleogram measures and records electrical responses from the cochlea. This test is often used in conjunction with your medical history and other tests to diagnose a vestibular disorder called endolymphatic hydrops.
Dizziness & Balance Treatment
Treatment is typically managed at one of Heuser Hearing Clinic’s Louisville locations, but in cases where other professionals are needed, we have an extensive referral source as well as on-site multidisciplinary management.
There are multiple treatment options available for vestibular disorders. After your balance assessment is complete, your doctor will explain your diagnosis and the best treatment options for your needs. Most vestibular disorders causing dizziness and imbalance can be treated or managed effectively. Recommendations may include physical or vestibular therapy, medication, diet management and in rare cases, surgical intervention.
Vestibular Rehabilitation Therapy
Vestibular rehabilitation therapy (VRT is a great treatment option as it doesn’t require patients to commit to taking a long-term medication, change their lifestyle or undergo surgery
This therapy program works to retrain your central nervous system to compensate for vestibular deficits. It can be used to treat most balance problems associated with the inner ear including:
- Benign paroxysmal positional vertigo (BPPV)
- Vestibular hypofunction from Ménière’s disease
- Vestibular neuritis
- Other inner ear disorders
- Post-surgery rehabilitation
Vestibular rehabilitation therapy is typically administered by a specialist, though your audiologist or otologist may also help to develop your individual treatment plan. In order to develop an individualized VRT process, you’ll undergo a complete evaluation that includes some basic coordination tests.
Based on this evaluation, your specialist will develop a series of head, body and eye exercises that you will perform in clinic and at home. These exercises may intensify symptoms of vertigo or dizziness at first, which can be discouraging for some people. However, after your brain adapts to the exercise, you will be amazed at how effective these exercises prove to be.
Dizziness & Balance FAQS
Sometimes I experience dizziness. Do I need to get tested for a vestibular disorder?
Even if your dizziness or vertigo symptoms are not serious enough to affect your lifestyle, they are likely to worsen over time. We recommend that patients visit our vestibular center for balance testing before the symptoms increase, as imbalance can create a safety concern. If we are able to pinpoint the cause of your dizziness, treating the underlying condition or managing your symptoms may be easier now than later.
Can I still take medication prior to vestibular testing?
Certain medications may change the results of your test. Medication prescribed specifically for dizziness should not be taken. We encourage you to follow the provided instructions that prohibit most medications that are not considered life sustaining.
If you are unsure, contact your prescribing doctor. Do not discontinue medications for blood pressure control, cardiac or circulatory problems, diabetes or other medications for similar medical disorders. If you have any questions or concerns about medications, please call us at (502) 563-1645.
How should I prepare for vestibular testing?
Do not eat or drink anything for three hours before the time of the test. On the day of the test, please do not drink any caffeinated beverages, use any tobacco products or wear makeup or face cream. We ask that you do not take any nonessential medications for 48 hours prior to your appointment time. Please avoid taking the following:
- Anti-dizzy pills
- Sleeping pills
- Over-the-counter cold or allergy medication
- Alcoholic beverages
How does the inner ear work?
The inner ear is divided into three main parts: the cochlea, the vestibule and the semicircular canals. The cochlea is responsible for hearing. The other two parts play a role in balance maintenance. The vestibule is a dome-shaped area between the cochlea and semi-circular canals. Its primary role is to let you know how much you are moving forward and backward. The semi-circular canals tell you where your head is in space and provides information relative to angular acceleration.
The ear works in conjunction with your vision, muscles and sense of touch to help you maintain your balance. Misleading information from any of these areas can cause a patient to feel dizzy or unbalanced. Vestibular testing is designed to identify the weakest part or parts of the system so that correction can follow.
Call Heuser Hearing Institute at (502) 584-3573 for more information or to schedule an appointment.