Balance & Dizziness

Dizziness or vertigo is a common problem in older adults, (NIDCD, 2014). Symptoms can include a simple feeling of imbalance and a more pronounced sensation of spinning. When experiencing these symptoms, it is important to be evaluated by a professional. Select Hearing Health USA locations provide balance testing and can work with your medical doctor to help create a treatment plan appropriate for your diagnosis. It is important to recognize and understand when to seek emergency medical attention. If you are experiencing recurrent or sudden, severe dizziness, falling, severe headache, chest pain, numbness, or shortness of breath, you should pursue emergency medical care immediately.

What is Vertigo?

Vertigo can be experienced as imbalance, spinning, rotating or falling. Your sense of balance is associated with your eyes and inner ear that help detect gravity and visually localize or fixate your position. When your brain experiences false messages about your surroundings from your ears or eyes, it incorrectly perceives the world around you and you experience vertigo.

Causes of Dizziness or Causes of Vertigo

There are many possible causes of vertigo. These include inner ear disturbance, fluid in the middle ear, side effects of certain medications, injury or other underlying health problems.

What is Balance or Vestibular testing?

Videonystagmography (VNG):

VNG is an assessment commonly used to evaluate the function of the vestibular system, that includes the balance portions of the inner ear, as well as the vestibular nerve and brain) The patient wears special goggles, which contain sensitive cameras focusing on the eyes. As the patient is asked to perform several tasks involving visual focus, the eye movements are carefully recorded and analyzed, which provides important information about the function of the peripheral (ear) and central (brain) vestibular function. The most important part of the VNG is the caloric evaluation, which provides diagnostic information about the strength of the peripheral vestibular system of each ear. During this test, cool and warm air is introduced into each ear canal and focused on the tympanic membrane (ear drum). The resulting nystagmus (eye-jerking movements) are recorded and analyzed. The VNG takes approximately one to two hours to complete.

Dizziness Treatment

Canalith Repositioning Maneuvers:

The most common type of vertigo is Benign Paroxysmal Positional Vertigo (BPPV), more commonly called “positional vertigo”. The condition is characterized by a brief but intense spinning sensation provoked by head movements (lying down, bending over). It is caused by displacement of otoconia (tiny inner ear crystals) into one of the semicircular canals of the inner ear. Treatment is usually very effective, and involves a maneuver called Epley, in which the head is placed into specific positions with the goal of “repositioning” the otoconia into a benign position. Testing for BPPV is typically performed as part of the VNG battery.

Central vertigo is less common and may be caused by problems with the brain stem or back part of the brain (cerebellum). A neurologic evaluation may be recommended if central vertigo is diagnosed.

It is most important to identify the type of vertigo you are experiencing in order to provide the best treatment or referral. If you or a loved one is experiencing vertigo or dizziness symptoms, contact your physician’s office to receive the appropriate care.