Diagnosing Vestibular Disorders

Though dizziness and balance problems are more common in older adults, they can happen to anyone at any age.

If you’ve struggled with these issues, you also may have struggled with getting an accurate diagnosis for the problem. And because of that, you may have had trouble finding treatment.

So why is getting a diagnosis for dizziness and balance disorders such a challenge for patients and physicians?

One key issue is that many patients have a hard time accurately describing what they are feeling. This makes it tough for physicians to pinpoint the problem.

If you’re experiencing dizziness or balance problems, be sure to make precise notes for your provider. For example, do you have the illusion of movement, such as spinning, up and down or side-to-side dizziness? Most often, that’s defined as vertigo. In fact, according to the Vestibular Disorders Association, 80% of patients with the symptom of vertigo have an inner ear disorder.

But dizziness also can be caused by a long list of health problems unrelated to the inner ear, including:  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 is also a common side effect of certain drugs, and it can be caused by exposure to toxic chemicals. Many of these problems can be life-threatening, so be as specific as possible in explaining your symptoms to your provider. That will help them sort through the list of potential causes.

If it’s determined that the problem is most likely originating in your inner ear, there could be a number of causes. The most common cause of vertigo is Benign Paroxysmal Positional Vertigo (BPPV), but disorders such as Ménière’s disease, migraine, vestibular neuritis, otosclerosis, labyrinthitis, acoustic neuroma and perilymph fistula, along with head trauma or a whiplash injury also can cause dizziness.

Because pinpointing the exact cause of dizziness can be complicated, it may take visits to several healthcare providers and specialists before arriving at an exact diagnosis. This process can be frustrating, requiring patience and persistence. 

Accurate Diagnosis

An accurate vestibular diagnosis requires special expertise and equipment. Many primary care providers may be able to assess whether your blood pressure or a medication is potentially causing your dizziness. But most don’t have the sophisticated equipment in their offices to assess problems related to the inner ear. Instead, they may refer you to a specialist like a vestibular audiologist, otolaryngologist, otologist or neurotologist who can order the tests necessary to measure hearing, eye movement and peripheral vestibular function. The specialist also may order an assessment of balance and functional impairments.

Associated Audiologists has one of the few programs in the region specializing in diagnosing and treating dizziness and balance disorders. Staffed by Danielle Dorner, Au.D., vestibular audiologist, and David Paul, Au.D., audiologist, these professionals offer a comprehensive battery of dizziness and balance testing including:

  • 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)

A number of well-researched, successful, and widely used management strategies are available for problems of the equilibrium system. These strategies address issues such as vertigo, dizziness, lightheadedness, and balance problems. All forms of management should be preceded by a comprehensive evaluation. This ensures that the specific strategy chosen is appropriate for you.

By evaluating and properly managing inner-ear disorders, dizziness and imbalance can often be improved or resolved.

Dr. Dorner and Dr. Paul see patients at our Overland Park Clinic.

Schedule an appointment with a vestibular audiologist for a comprehensive evaluation.