HearWell for Life- Hearing FAQ

Balance and Dizziness - Frequently Asked Questions

What causes balance disorders and dizziness?
What should I do first if I have balance problems or dizziness?
Why do I need testing?
What tests might be ordered?
How does the VNG test work?
How do I prepare for the test?
What treatments are available?
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So, what causes balance disorders and dizziness?

A sense of balance is maintained by the nervous system and the complex interaction of its parts. To better understand how dizziness balance problems and vertigo occur, it is important to understand these systems and their relationship to each other.

Vestibular/Balance System: This system includes the vestibular labyrinth, an organ in the inner ear that plays a major role in balance. The vestibular system assesses the motion of the head, such as turning, or tilting and moving forwards or backwards.
Visual System: This system is responsible for the body’s relationship to its surrounding space. When the eyes are unable to focus on a moving object, dizziness or unsteadiness may occur.
Vascular System: This system involves blood flow. If the brain does not receive enough blood, a light-headed sensation might occur. Problems with circulation can often lead to frequent or chronic balance issues.
Somatosensory system: This system monitors the body and its relationship to the ground. Sensors on the soles of the feet provide valuable information to the leg and torso muscles.
Central Vestibular System: This system consists of the brain and/or connecting nerves. This is an important system, for it focuses on the coordination of all the bits of information provided by the other systems and tries to make sense of them.

Balance disorders can be caused by problems with any of the above systems. Infections, head injuries, blood circulation disorders, certain medications, eye muscle imbalance, and-or injuries to the visual or skeletal systems are a few causes of balance problems. Balance disorders are serious. If you believe your balance is impaired, you should see a physician.

What should I do first if I have balance problems or dizziness?

You should start with an appointment with your primary care physician. They may recommend several different options based on your symptoms.

Referral to an Otolaryngologist
Referral to an Audiologist
Referral to a Neurologist

Why do I need testing?

To determine if the reason for your balance problems or dizziness is due to an inner ear dysfunction.
To identify an inner ear problem through the use of a test that is more accurate than a clinical examination.
To objectively document BPPV and Perilymph Fistula.
To determine which vestibular treatments are necessary.
To determine if an MRI, generally a more expensive test, is necessary.

What tests might be ordered?

We offer a variety of tests to properly diagnose the cause of your dizziness or balance problem:

Video Nystagmography (VNG): This test looks at the patient’s control of eye muscles, the central vestibular system, and the inner ear function.
Computerized Test of Dynamic Acuity: This test determines the smooth tracking of eye movements.
Auditory Brainstem Response (ABR): This test looks at the brainstem area of the central pathway.

How does the VNG test work?

There are three major parts to the Video Nystagmography test:

Visual Test: An evaluation of the patient’s eyes as they follow a visual target such as a light.

Positional Test: An evaluation that measures eye movement in relationship to body and head positions. (The patient is asked to assume different positions, sitting and lying down.)

Caloric test: an evaluation that measures the vestibular system’s response to warm and cool air being circulated through the patient’s ear canal.

How do I prepare for the test?

In order to achieve the best results, we ask you to do the following:

Schedule a driver to pick you up after the test.
Remove contact lenses before testing.
Wear comfortable clothing.
Wash face thoroughly –– no creams or makeup on the face, especially mascara or eyeliner.
No solid foods or milk two to four hours before test.
No aspirin or medication containing aspirin for two days prior to test.
No caffeinated drinks, alcoholic beverages/liquid medications with alcohol for 48 hours prior to testing.
Discontinue all medications 24 hours prior to testing except those taken for heart, blood pressure, depression or seizures. Stop allergy, sleeping pills, decongestants, pain, diet or dizziness medications.
If you have any questions about your medications please call the office

Allow one hour for the VNG and 30 minutes for the hearing test, if ordered.

What treatments are available?

There are many treatments for dizziness, and they are prescribed based on the diagnosis. To date, optional treatments include:

A variety of positioning maneuvers and exercises for BPPV
Rehabilitation for stabilized vestibular functions
Diet
Medications
Surgery
Eye exercises