Restoring Balance Starts With Testing

What Is Balance Testing?

Balance testing tells our provider what disorder might be causing you to feel unsteady on your feet. Diagnostic testing is an important step in finding the treatment that will best fit your needs.

How Does Audiometry Help Diagnose Balance Disorders?

This exam measures your ability to hear different sounds, pitches and frequencies. In a sound-proof room, you will wear headphones connected to a device that sends sounds to one ear at a time. Our audiologist will ask you to press a button or raise your hand whenever you hear a sound.

Because the ear plays an important role in balance, results from a hearing test can help discover where the balance problem is located. An audiometry test may help our provider gain more information about your balance disorder.

What Other Tests Are Used To Diagnose Balance Disorders?

• Acoustic Immittance Measures: These tests evaluate the eardrum and middle ear and are used to determine which part of the ear is affected by hearing loss. 
• Auditory Brainstem Response: This test provides information about the electrical activity in the auditory pathway between the inner ear and the brain.
• Electronystagmography: This test measures eye movements to determine how the vestibular system is functioning. Electrodes are placed around the eye to record electrical activity and detect involuntary rapid eye movements.
• Electrocochleography: This test looks at the ratio of fluids in the inner ear.
• Otoacoustic Emissions test: During this procedure, a small probe is inserted into the ear to determine the response of hair cells in the inner ear.
• Videonystagmography: This technique, which detects involuntary eye movements, involves measuring the response of your eyes to moving dots, head and body movements and water or air in the ears.
• Posturography: During this test, you will stand on a platform, and your posture and balance will be measured under various conditions.

When Is Balance Testing Done?

Balance Testing for Vertigo

A common reason for feeling unsteady on your feet is vertigo. This occurs when signals from the vestibular system to the brain about the position of the head in relation to movement are disrupted. It is most often the result of a problem in the middle ear. Balance testing can help determine if you’re experiencing vertigo and is the first step in getting the best treatment for your symptoms.

Balance Testing for Sports

Balance testing is also important for fitness and sports like tennis and football. It’s valuable for athlete safety, particularly if they may be experiencing a concussion. Useful tests in this category include the Balance Error Scoring System and the Sensory Organization Test.

What Should I Do if I Think I Have a Balance Disorder?

If you’re exhibiting signs of a balance disorder, like dizziness or feeling faint, we can provide diagnosis and treatment for you. Whether your symptoms come and go or are consistent, we’re here to support you.

Diagnostic Tests for the Vestibular System

The vestibular system is complex and responsible for many of the body’s functions. In order to narrow down the exact cause of dizziness, it is necessary to administer a variety of tests. These measure eye movements, head movements, hearing and more.

Studies indicate vestibular testing is extremely thorough and accurate in identifying inner ear disorders. Vestibular testing is also helpful in determining whether additional diagnostic testing, such as an MRI, is needed. A battery of tests is administered in most cases. The most common ones include:

• Electronystagmography (ENG). This series of tests measures eye movements via electrodes placed around the eyes. ENG tests usually consist of four parts: evaluation of rapid eye movements, tracking tests to measure eye movements as they follow a visual target, positional test for measuring dizziness in response to different head positions and a caloric test that measures responses to warm and cold water circulating through a tube in the ear canal. Most people reporting dizziness or vertigo will be given ENG tests initially.
• Videonystagmography (VNG). This is similar to ENG testing, but an infrared video camera attached to a pair of goggles is used in place of electrodes. The same four-part testing process is utilized.
• Rotary Chair Tests. The rotary chair test measures eye movements in response to corresponding head movements; it is used to determine whether symptoms are related to an inner ear disorder or a brain disorder. Like the ENG and VNG tests, either electrodes or a goggle-mounted video camera is used to record eye movements. You are seated in a computerized chair that moves. This test provides more detailed information about the function of the balance system than an ENG or VNG test.
• Computerized Dynamic Posturography (CDP). CDP tests measure how well the visual, vestibular and sensory systems work together to maintain balance. With this test, you stand on a platform and follow a visual target while platform movements record the degree to which your body sways. It includes an Adaptation Test in which the platform moves up and down and a Motor Control Test where the platform moves forward and backward. These are used to measure reflexive responses to unexpected movement. CDP is frequently used those undergoing vestibular rehabilitation.
• Vestibular Evoked Myogenic Potential (VEMP). VEMP testing is used to determine whether the saccule (an inner ear organ) and vestibular nerves are functioning properly. Electrodes are attached to the neck and sounds are transmitted through a pair of headphones. The electrical response of the sternocleidomastoid muscle in the neck is recorded.

These tests may be combined with additional hearing or diagnostic tests depending on the results.