Vestibular (Balance) Evaluations
Vertigo, dizziness, and balance problems can be life altering. For many people it can affect their ability to do even the simplest daily tasks. If you are experiencing vertigo or balance issues, your doctor may want to refer you for a Vestibular (Balance) evaluation. A vestibular evaluation may include VNG, ECochG, and/or ABR Testing.
Videonystagmography (VNG): This test is used to determine if a vestibular (inner ear) disease may be causing a balance or dizziness problem. VNG is one of the only tests available today that can decipher between a unilateral (one ear) and bilateral (both ears) vestibular loss. VNG testing is a series of tests designed to document a person’s ability to follow visual objects with their eyes and how well the eyes respond to information from the vestibular system.
This test also addresses the functionality of each ear and if a vestibular deficit may be the cause of a dizziness or balance problem. To monitor the movements of the eyes, infrared goggles are placed around the eyes to record eye movements during testing. VNG testing is non-invasive, and only minor discomfort is felt by the patients during testing as a result of wearing goggles.
Electrocochleography (ECochG): This is a complex test designed to record the electrical activity of the cochlea, a part of the inner ear. This test is commonly done to diagnose a condition called Meniere's Disease. The ECochG is performed by placing a very thin and small electrode into the ear canal as close as possible to the tympanic membrane (eardrum). The ear is then stimulated with sounds. These sounds are transformed into vibrations in the middle ear --your ear does this naturally and automatically all the time. The vibrations are turned into electrical impulses in the inner ear and are recorded and measured using computer software.
Auditory Brainstem Response (ABR): This exam tests both the inner ear system and the cranial VIII nerve pathway up to the brainstem. This test measures the timing of different electrical waves in response to sounds in the ear. The sound is delivered through insert earphones and electrodes are typically placed behind the ears and forehead to measure the responses.
An ABR test will allow us to see if there is a "block" along the cranial VIII nerve pathway that leads to the brainstem. Common "blocks" include tumors, infections, and degeneration to the nerve itself.
Preparing for Balance Testing
Because of the nature of the tests, there are some preparations you will need to make before your evaluation. Our staff will provide you with clear instructions on how to prepare for your examination. For example, we may ask you to discontinue certain medications, not to consume any alcoholic beverages or caffeinated drinks at least 48 hours before the tests, to remove contact lenses or eyeglasses or to fast for a few hours prior to testing. The exact instructions may vary from patient to patient. If you have any questions about your instructions or how to prepare for the test, ask your audiologist.
The entire evaluation typically lasts about 120 minutes and can cause some dizziness. This dizziness usually subsides within a short period of time. It is advised that you bring someone with you who can drive you home afterward if you are unable to drive or do not feel well after the tests.
Treatment of Balance Disorders
Treatment of balance disorders depends on the diagnosis, but usually consists of Vestibular Rehabilitation and Balance Retraining. At PA Center for Hearing and Balance; we work in conjunction with The Center for Dizziness and Balance at Springfield Hospital, to tailor an individual treatment plan that is designed for each patient based upon the patient's history, the findings from the diagnostic testing performed and the functional limitations caused by the imbalance.