Balance Testing

Balance disorder treatment awareness phoenix arizona

 Head-spinning dizziness … or just a little stumble? If your balance seems unsteady, call ABHA. We know what to do.

Call us at: (602) 265-9000

 

We’ll quickly find out why you feel unsteady …

At Arizona Balance & Hearing Aids, our audiologists utilize leading-edge techniques to test and evaluate your overall balance system. With these results, our team is able to provide you with a professional recommendation for treatment. 

Each balance test focuses on a specific area, always with the goal of pinpointing exactly where and how your balance system is being compromised. Testing is painless and non-intrusive. Once we find the affected area, we can choose from those many different treatments and therapies to alleviate the problem or correct it altogether. If you or a loved one are experiencing issues related to your balance, we invite you to schedule an appointment at our Central Phoenix practice. Learn more below about the different kinds of balance tests we offer. 

Check out our quick guide to balance disorders by clicking here.

Symptoms of Balance & Vestibular Disorders

Symptoms:

Symptoms of balance disorders present themselves differently for different people. Most people with balance disorders will feel like they are floating, spinning or moving when standing, sitting or lying down. Some people will feel faint when standing or as if they may suddenly tip over. Others may stagger when walking or experience blurred vision and/or disorientation and confusion. Vertigo is also a symptom of some balance disorders. Vertigo is the feeling of intense spinning that lasts for quite a while.

Symptoms of chronic dizziness or balance issues can severely impact a person’s ability to perform basic daily living skills, and can lead to anxiety, fatigue or depression.

It is important to talk to a professional if you experience dizziness or balance issues beyond normal and very periodic dizzy spells when standing up too quickly, or when you are dehydrated.

Causes:

Your risk for balance and vestibular disorders increases as you age and there are multiple factors that may cause them. Bacterial or viral infections, a head injury, ear infection or certain medications can cause balance issues and dizziness. Issues with the skeletal or visual systems can also cause vestibular concerns. Dizziness and lack of balance are also often the symptoms of another underlying medical issue.

Oftentimes, these types of issues will occur without any obvious or apparent cause.


Dizziness Test (ENG/VNG)

Electronystagmography (ENG)/
Infrared Videonystagmography (VNG)

eng-vngThis is usually the first test your doctor will order for dizziness or loss of balance, because it evaluates both the central and peripheral aspects of your overall balance system.

There are three stages to the test, and you will need to stay alert and keep your eyes open most of the time. The entire test lasts about an hour, as we carefully measure and evaluate each stage.

First, you will be asked to follow moving lights with your eyes.

Second, you will be moved into various sitting and lying positions on a table. (Simple as that!)

Third, warm and cool water or air will be introduced gently into your ears for a short period of time. (This is called the “caloric” part of the test.)

These tests will indicate:

  • Suspected positional vertigo (dizziness caused by change of position)
  • Vestibular neuritis/Labyrinthitis (irritation or swelling of the inner ear)
  • Meniere’s (MAY-nee-ers) Syndrome (a buildup of fluid in the inner ear that can cause dizziness)
  • Central vestibular or cerebellar dysfunction

Rotary Chair Test (RC)

rc1In this balance test, a computer-driven chair rotates clockwise and counterclockwise in a regulated way.

This test takes up to 30 minutes to complete. You will need to stay alert and keep your eyes open.

This test will indicate:

  • Suspected bilateral balance loss
  • Perforated eardrums
  • Otoxic drug exposure (medications that are harmful to hearing/balance system) or low responses to caloric tests.
  • Suspected cerebellar disease or central balance dysfunction

Listening Test (EcochG)

Electrocochleography

This is a balance test. You relax in a comfortable recliner with your eyes closed. We will gently place a few electrode pads onto your head. At this point we will play clicking noises through the earphones. The EcochG test lasts about 15-30 minutes. 

This test is often used in the diagnosis of Meniere’s Syndrome.

Listen & Lift Test (VEMP)

Vestibular Evoked Myogenic Potential (VEMP)

This is a recently developed, specialized test for balance. We’ll place a few electrode pads gently on your neck, and then play some clicking noises through the earphones that you’ll be wearing. While you lie back in a comfortable recliner during the entire test, we’ll ask you to turn your head in a certain directions, and to lift your head for a few seconds while each recording is taken. This test takes about 30 minutes.

This test will indicate:

  • Suspected Superior Canal Dehiscence (thinning or absence of a portion of a bony canal in the inner ear balance system)
  • Tullio Phenomenon (dizziness caused by loud sounds)
  • Imbalance or dizziness of uncertain origin

Light Alignment Test (SVV)

Subjective Visual Vertical Test (SVV)

This is where you get a job to do. We’ll sit you in a chair that rotates clockwise and counterclockwise at a comfortable speed, and your task will be to adjust a lighted bar to the vertical position both while the chair is rotating, and when it’s at rest. Simple enough. This test takes about 15 minutes.

This test will indicate:

  • Suspected utricular dysfunction (abnormal sense of tilt, acceleration or gravity)
  • Imbalance or dizziness of uncertain origin

Positional Test (BPPV)

Positional Vertigo (BPPV) Test and Treatment

If you’ve experienced a brief spinning or off-balance feeling that comes and goes … lasting for just a short while … you may be experiencing Benign Paroxysmal Positional Vertigo (BPPV). Most people do.

It’s not nearly as serious as it sounds, and it can usually be fixed quickly and easily.

BPPV happens when tiny crystals in your inner ear (“otoliths”) have fallen out of place. The treatment is simply to move you into a few different but very specific head and body positions. This is called Otolith Repositioning, and we can do it on the same day as your tests.

Here at ABHA, we do Otolith Repositioning pretty much every day, on patients with classic mild cases of BPPV, as well as more complicated cases. Patients respond very well: this procedure has a very high success rate.

Balance Disorder Types and Treatments:

This is the most commonly diagnosed vestibular disorder. In fact, it is the cause of about 50% of cases of dizziness in older adults. BPPV usually presents itself as a short but very intense sense of vertigo (extreme spinning sensation) associated with the movement of one’s head. This could include extreme dizziness when bending down, looking over one’s shoulder or changing positions while attempting to fall asleep. While vertigo is most common, patients may also experience dizziness, faintness, loss of balance or nausea.

BPPV is caused by some pieces of calcium carbonate crystals or (otoconia) becoming dislodged and migrating into the three semicircle canals within the labyrinth of our inner ear. These semicircle canals control our sense of balance and become obscured when this occurs.

Treatment for BPPV:

Luckily, most cases of BPPV are extremely simple and can be treated on the same day during the same doctor’s visit. We will move your head in comfortable but carefully calculated positions in order to guide the otoconia back to its proper location. In very rare cases, surgical options are considered.

Although the exact culprit for causing Ménière’s Disease is vastly unknown, it is the symptom of build-up of fluids in the labyrinth, or compartments of our inner ear. There are multiple theories surrounding the exact cause for the disease. People with Ménière’s Disease often experience extreme dizziness, vertigo, hearing loss, and a feeling of fullness in the ears. Some people experience the attacks of dizziness after a temporary period of tinnitus or garbled hearing, and others experience it completely randomly. Ménière’s Disease can cause attacks of vertigo that are so extreme that patients may fall over.

Treatment for Ménière’s Disease:

Currently, there is no cure for Ménière’s Disease, although there are some options available to relieve the symptoms. Changes to diet or behavioral habits can be a very effective means to combat symptoms. If you are a smoker, quitting can greatly reduce the issue. Medication may also be prescribed.

Labyinthitis, pronounced [lab-buh-rinth-EYE-tiss] is often associated with an upper respiratory issue such as the flu. It is caused by an inflammation or a viral infection that affects both branches of the vestibule-cochlear nerve in the inner ear. People with labyrinthitis will often experience dizziness and vertigo, coupled with hearing changes or tinnitus. Labyrinthitis exists in two phases, acute and chronic. In the acute phase, the onset is extremely sudden and very disorienting. It is so intense, that most people will visit a doctor right away for treatment. If the virus damaged the nerve, a patient may enter the chronic phase. In the chronic phase, one may feel a constant disorientation, making everyday activities such as grocery shopping or working on a computer exhausting and frustrating.

Treatment for labyrinthitis:

For acute labyrinthitis, medications are usually prescribed that take care of the symptoms. For chronic cases, additional testing may be needed to determine if another type of vestibular issue is concurrently effecting your balance and hearing. If the dizziness, hearing loss and tinnitus last for months, vestibular rehabilitation exercises may be the appropriate treatment.

Contact us today to schedule your appointment

Dr. Dana Day provides comprehensive balance testing in Central Phoenix.
Contact our friendly team to schedule your test.

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