Dizziness and Balance
Vertigo, or dizziness, is a symptom, not a disease. The term vertigo refers to the sensation of spinning or whirling that occurs as a result of a disturbance in balance (equilibrium). It also may be used to describe feelings of dizziness, lightheadedness, faintness, and unsteadiness.
Vertigo usually occurs as a result of a disorder in the vestibular system (structures of the inner ear). The vestibular system is responsible for integrating sensory stimuli and movement and for keeping objects in visual focus as the body moves.
Vertigo is one of the most common health problems in adults. According to the National Institute of Health (NIH), about 40% of people in the United States experience feelings of dizziness at least once during their lifetime. Prevalence is slightly higher in women and increases with age.
If you are experiencing vertigo, you should call us to make an appointment. At PA Center for Hearing and Balance we will complete a thorough diagnostic evaluation to help you understand why you are having vertigo as well as to help you get better.
Causes of Balance Disorders (Dizziness, Vertigo, Imbalance or Disequilibrium)
85% of all balance disorders are the result of problems involving the inner ear.
Dizziness can be caused by diseases such as Meniere’s disease, by small calcium deposits in the inner ear (otoconia), drugs which are toxic to the vestibular (balance) system, head trauma, and other conditions not necessarily related to the vestibular system. Any disturbance in the inner ear, with or without hearing loss or ringing in the ears (tinnitus), may cause a feeling of dizziness.
When is a balance assessment indicated? – Vestibular or balance system assessment is indicated when a person has nystagmus (rapid involuntary eye movement), complaints of vertigo (dizziness) balance dysfunction, gait abnormalities, or when pathology/disease of the vestibular system is suspected.
Diagnosis of Balance Disorders
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.
Treatment of Balance Disorders
Treatment of balance disorders depends on the diagnosis, but usually consists of Vestibular Rehabilitation and Balance Retraining. A treatment plan needs to be tailored to each patient based upon the patient's history, the findings from the diagnostic testing performed and the functional limitations caused by the imbalance.