About Dizziness, Vertigo, and Imbalance

If you have dizziness, especially dizziness with movement, you are not alone. Statistics from the US National Institute of Health report dizziness/vertigo to be among the most common reasons for a doctor visit; right up there with back pain and headache.

  •   The overall incidence of dizziness/vertigo/ imbalance is about 10% of Americans
  •   Incidence reaches 40% by age 40
  •   Incidence is 60+% by age 80

After age 65, 25% of all falls involve dizziness/vertigo; of course with this age group the fall risk is compounded by other aging factors.

How our balance system works:

The balance organ is part of the inner ear. This part of the inner ear is called the vestibule. It consists of gravity sensing and linear and angular-acceleration sensing parts. It is amazing. The gravity sensing organs use crystals of calcium carbonate to determine which way is up and down. The linear and angular acceleration sensors are hydraulic; and use fluid dynamics to describe movement. The right and the left ear have a full set of all the parts of the balance system. The central nervous system depends on equal and opposite stimulation from the right and left sensors to describe and prepare for balance. Anything which affects one side and not the other is typically experienced as dizziness.

Dizziness testing and treatment:

There is much that can be done to remove or reduce dizziness symptoms. But first you need a diagnostic test to determine the cause of your problem. Because the balance system is part of the inner ear, often both hearing and balance are affected. This system is largely inaccessible for viewing, so a balance assessment is done by a combination of tests which look at hearing, reflexes, eye movement, body movement and the effects of cooling and warming each ear.

We provide videonystagmography (VNG) testing to evaluate patients’ balance difficulties. The VNG test records and measures voluntary and involuntary (nystagmus) eye movement using an infrared video camera. VNG testing assists the patient’s physician in developing a medical and/or rehabilitative plan for improving balance function.

What does the test involve?

The test is painless and is scheduled for 2 hours. The first part is your interview and a very complete hearing evaluation seeking certain dizziness problems which show up on your hearing test. For the second part of the exam, we measure the balance system through your eyes. How? Your eyes are sent in the direction your balance system believes it is moving, ahead of that movement. By recording eye movement and analyzing, it we can learn quite a lot about your balance system. To record your eyes you wear a pair of video goggles. The goal of the test is to find out which part of your system is causing your symptoms and help determine how to eliminate or improve this problem.

Please also see test instructions.

What can you gain from this testing?

Many problems causing dizziness or imbalance are removable or improvable. An accurate assessment of the level of your balance/dizziness problem leads to less dizziness, decreased risk of falling and injuries, and maybe even better sports performance!

At the end of the test the Audiologist will review your results with you, and will also send you and your primary care provider a full report in order to find a solution specifically tailored to your needs.