Balance Testing

What can a balance test tell you?

Balance tests help you determine what’s causing vertigo or dizziness. Balance issues often stem from issues in your inner ear and can be diagnosed through a series of tests.

Common balance tests

Vertigo and dizziness can be caused by many things, from a common cold to an ear infection, to more serious health conditions. To help determine what’s causing your balance issues, we may administer the following tests.

Hearing tests

Getting a hearing test will rule out common issues such as impacted earwax, ear infections and fluid behind the ear.

Videonystagmography (VNG)

Videonystagmography is a balance test using electrodes to measure changes in eye movements as you change positions. This procedure takes about an hour and will help us determine whether your balance problems are related to repetitive, uncontrolled eye movements.

Pre-Test Preparation: Do not eat or drink for at least 4 hours prior to the exam unless you are diabetic, in which case please maintain your normal eating schedule, do not take medications that have been prescribed for dizziness for 48 hours before the exam, do continue to take other medications especially for cardiac, diabetes and blood pressure problems, do not wear eye make-up to the appointment (if you do, you will be asked to remove it).

Vestibular Evoked Myogenic Potentials  (VEMP)

VEMP testing is commonly performed on patients complaining of dizziness, vertigo, or imbalance, and is often conducted during the same visit as the VNG evaluation to obtain a comprehensive understanding of your inner ear function. The purpose of the VEMP evaluation is to determine if portions of your inner ear, specifically an organ called the saccule, as well as a branch of the auditory nerve, are intact and working normally. The test involves placing electrodes on your neck and putting earphones into your ear which will produce a rather loud clicking sound. You will be asked to recline in a chair and to raise and hold your head up for about one minute. This cycle will be repeated several times.

Pre-Test Preparation: Do not wear a turtleneck shirt, do not take any medications that have been prescribed for dizziness for 48 hours before the exam.

Epley (Canalith Repositioning) Maneuver

One of the most common causes of dizziness is Benign Paroxysmal Positional Vertigo or BPPV. BPPV is caused by calcium particles that become lodged in areas of the inner ear where they should not be. When this occurs, it can cause you to experience a brief spinning sensation when your head is put in certain positions. Commonly, people with BPPV report dizziness when they look up, bend over, or roll over in bed. Fortunately, BPPV is highly treatable with a procedure called canalith repositioning.

Because of the connection between your inner ear and your eye muscles, you will wear goggles to monitor your eye movements during the exam. The audiologist will guide you from a sitting position into a reclined position to determine where in the inner ear the calcium particles have lodged. From there, the audiologist will maneuver your head and body to roll the particles out of the problem area. While BPPV is often resolved after the first treatment, additional treatments are sometimes necessary.

Pre-test Preparation: None. However, it is recommended that following the treatment you avoid activities that would have brought about your dizzy symptoms for the remainder of the day. If you have been taking medication to control nausea, you can continue to take this medication on the day of the procedure. It will not affect this test.