Balance Tests + Getting Accurately Diagnosed For Dizziness & Balance Disorders

How Imbalance Can Feel

Dizziness and balance disorders can be difficult and frustrating conditions to diagnose for patients. One reason is because patients often have a difficult time describing their symptoms in a meaningful way to their healthcare providers.

Vertigo is the most specific symptom many patients experience, and it has a specific definition—it is an illusion, or feeling, of movement. That movement may be felt inside of the person, or the person may have the perception of movement of the environment around them. The movement may be perceived as spinning, up and down, or side-to-side dizziness, giddiness, floating, lightheadedness or a less easily defined feeling.

Some people undergo test after test and still do not receive a diagnosis, but about 80% of patients with the symptom of vertigo have an inner ear disorder.

Common Causes of Dizziness

Dizziness also can be caused by problems that have nothing to do with the inner ear. Some of these problems include anxiety, arrhythmia, stroke, heart attack, defective heart valves, orthostatic hypotension, hardening of the arteries, hypothyroidism, hypoglycemia, epilepsy, brain tumors, and congenital malformations of the brain or skull. Dizziness also may be a side effect of certain drugs, and in some cases toxic chemicals.

If the source of dizziness is the inner ear’s balance system, there are many types of inner ear disorders that can cause vertigo. The most common is benign paroxysmal positional vertigo (BPPV). Less common inner ear disorders include Ménière’s disease, vestibular neuritis, otosclerosis, labyrinthitis, acoustic neuroma and perilymph fistula. Other diseases that can affect the inner ear or the parts of the brain devoted to balance include migraine, allergies, multiple sclerosis, syphilis and other bacterial and viral infections, and diabetes. The inner ear can also be damaged by blows to the head or whiplash injuries. Anxiety can even cause dizziness.

While dizziness feels very real to the patient, it’s not something that a physician can readily observe, which can further complicate diagnosis. And even if your physician suspects a vestibular disorder, the complex equipment needed to confirm a diagnosis may not be available.

That’s why many patients with possible dizziness and balance disorders are referred to a doctoral-level audiologist who specializes in vestibular disorders, such as Danielle Dorner, Au.D., Vestibular Audiologist, Associated Audiologists.

Diagnosing Balance Disorders

Dr. Dorner offers a comprehensive dizziness and imbalance clinic for patients. This clinic uses state-of-the-art technology to evaluate individuals suffering from dizziness, balance problems, and/or who have a history of falls related to inner-ear disorders.

She offers patients comprehensive testing of the outer, middle, and inner ears. These tests include audiologic, tympanometry/immittance, and otoacoustic emission tests.

A number of complex pathways control the equilibrium. An evaluation includes sophisticated measures of these pathways and the central nervous system. These tests are:

  • Auditory Brainstem Response (ABR)
  • Electro-oculography
  • Video Head Impulse Test (vHIT)
  • Rotary Chair
  • Sensory Organization Performance (SOP)
  • Electrocochleography (ECOG)
  • Vestibular Evoked Myogenic Potential (VEMP)
  • Video/Electro-nystagmography (VNG/ENG)

Schedule an appointment with Dr. Dorner if you are experiencing symptoms. Or, for more information about dizziness and balance disorders, download our free e-book, What to Know about Dizziness and Imbalance.