Your sense of physical balance, or equilibrium, can be disrupted by irregularities in your inner ear.

These disruptions can cause dizziness and other balance disorders. If you are having issues with your balance, or often feel dizzy, it is important that you have one of the following tests performed to diagnose the issue and determine the cause.

Balance Tests

VNG (Videonystagmography)

Videonystagmography “V” using video and an infrared camera, “N” nystagmus or involuntary eye movements, “G” to graph measurements. The use of video goggles accurately documents eye movement using infrared signals. With this technology, we can not only measure the eye movements, but we can see them and capture video of their movement.

Your eye movements are directly related to what your inner ear (semicircular canals) is doing. They are the window into the function of the balance system. During the test, you will be asked to follow a light with your eyes while the movements of your eyes are being monitored. Then you will be moved in different simple body positions to determine if your balance system is responding normally. 

Finally, the audiologist will present cool and warm air to your ear canals. This will give you a sensation of spinning for a short time while your eye movements are being recorded. This test helps us to determine how well your vestibular systems are functioning. The audiologist will analyze the test and send the results to the referring physician for review.

Vestibular Evoked Myogenic Potentials (VEMP)

The vestibular evoked myogenic potential (VEMP) is a diagnostic test used to evaluate the health of specific balance organs and associated nerves. It is usually used in a battery of other tests (VNG, ECOG, ABR and/or a hearing test) to determine where your dizziness may be coming from. This test is completed by recording and measuring muscle responses from the neck or just below the eye while a loud clicking sound is played in the ears. Even if your hearing loss prohibits you from hearing the test sound, normal responses can be recorded. The tester will clean the skin of your neck, forehead, sternum (chest) and under the eyes. Small surface electrodes will be affixed to the skin in these areas. Earphones will be placed in each ear canal. You will lie comfortably on the exam table and turn and raise your head while the sound is played in the ear for up to a minute at a time. In addition, you may be asked to focus your eyes upward on a specified location while the sound is being played in the ear. The computer will record several responses from each ear. The audiologist will analyze the test and send the results to the referring physician for review.

What Is Causing My Unsteadiness?

Other causes of balance issues may include a head injury or ear infection. Low blood pressure can also lead to a feeling of dizziness if you stand up too quickly. Arthritis and eye muscle imbalances are also known to cause balance problems. Advancing age and even certain medications are other common causes of dizziness and balance problems.

How Are Balance Problems Treated?

First, we need to determine the cause of your balance issues, then we can recommend a treatment method.

For example, your balance issues may require a therapist to create a treatment plan especially for you. The plan would include balance retraining exercises to strengthen your balance, increase your energy levels and reduce stress.

There are also positioning procedures – specific head and neck movements that clear the inner ear canal and often improve balance issues.

Diet and lifestyle changes may also improve your balance problems. This includes quitting smoking, as well as reducing salt, caffeine, alcohol, nicotine and chocolate. Simple exercises, including walking and low-impact aerobics, may help, as well.

There are anti-vertigo and anti-nausea medications available to relieve balance disorders. The antibiotic gentamicin, or even corticosteroids, can be injected behind the eardrum for those with severe balance problems.

Surgery may be required to alleviate your balance problems if you have Meniere’s disease or another medical issue that can’t be remedied using less invasive methods.

Treatment of Positional Vertigo

Positional vertigo is the most common, and most misdiagnosed, form of true spinning vertigo. Particles in the vestibular system called otoliths (or “crystals”) become dislodged and enter another portion of the vestibular organ. This causes brief true spinning vertigo that occurs with head and body positional changes. The treatment for benign paroxysmal positional vertigo, BPPV, is a simple series of head and body positions performed by the doctor of Audiology. We must verify the size and location of the dislodged particles to utilize the correct repositioning treatment for you. The procedure only takes a few minutes to complete and most patients only require one treatment to completely resolve their positional vertigo. Unfortunately, this procedure is not covered by insurance when the audiologist performs it, so there is an out-of-pocket expense.