Balance & Dizziness
Your balance system helps you stand and move without falling. Your brain makes sense of information received from the nerves of your eyes, inner ear, muscles and joints to help you stay balanced. This complex system is known as your vestibular system.
Balance testing can help determine the cause of your dizziness or imbalance. Certain Audiologists or Acousticians with special equipment can perform diagnostic dizziness assessments. At the same time, you can expect to undergo a full diagnostic assessment of your hearing.
The test process determines the relationship between the components of your vestibular system. This will guide further medical and rehabilitation management.
Signs and Symptoms of a Balance Disorder
If your inner ear function changes suddenly (such as a viral infection), it results in a sense of dizziness or vertigo. This can feel as if the world is spinning or as if you are walking on a boat.
If your inner ear function changes slowly, it results in a sense of imbalance. Imbalance can also be aggravated by changes in vision, loss of muscular strength, or a loss of sensation in your legs and feet.
Dizziness: vertigo, light-headed sensation, confusion, spatial discomfort
Imbalance: a sense that you feel unsteady
Drop attack: unprovoked fall without the loss of consciousness
Balance Emergencies
You should see a doctor immediately if you experience any of these symptoms:
• Falling or problems walking
• Sudden hearing loss
• Sudden tinnitus
• Sudden blocked sensation in one ear
• Chest pains
• Numbness, tingling or weakness in your arms or legs
• Blurred vision
• Slurred speech
• Severe neck stiffness
• Head trauma or injury
• High fever
What to expect at your first appointment
At an appointment with an audiologist regarding balance and dizziness assessment, you can expect a comprehensive evaluation designed to investigate the cause of your symptoms.
The main aspects usually include:
Medical history and preliminary questions: Your audiologist will ask about your dizziness, balance issues, medical background, medications, and related symptoms to tailor the assessment.
Hearing tests: These may include pure tone audiometry (to test hearing sensitivity), tympanometry (to check eardrum and middle ear function), and speech audiometry. These tests help identify some conditions that affect both the hearing and balance organs.
Eye movement and vestibular tests: Using infrared video goggles or nerve/muscle-reading electrodes (perfectly safe and harmless), your audiologist records your eye movements while you follow targets or change head positions. This helps identify any issues with one of the eye-affecting reflexes that are driven by the inner ear balance organs. Tests can include videonystagmography (VNG), video head impulse test (vHIT), and positioning manoeuvres.
Balance function tests: You may be asked to stand on a force platform or foam cushion with eyes open or closed to assess how well your balance organs, eyes, and joints coordinate to maintain posture.
Caloric test: Warm or cool air or water may be introduced into your ear canals to stimulate the vestibular system and provoke eye movements (nystagmus), to compare the function of specific cells in the balance organs of each side. Relative weakness and strength can help to identify the type of problem and whether it is specific to one side.
Vestibular-evoked myogenic potentials (VEMP): This test may be done to assess specific inner ear sections that detect gravity, vertical and horizontal acceleration. Results can indicate involvement of these organs.
The entire appointment may take between 1 to 4 hours depending on the complexity of your problem. Some tests might temporarily elicit your dizziness, so it is advisable to arrange for someone to transport you or, to avoid driving immediately afterward.
Your audiologist will explain each test before performing it. Results of individual tests are rarely definitive in isolation, and so audiologists may need to fully interpret the waveforms and patterns of the results. They may be discussed with you immediately, or, in certain cases, you may need to return for discussion. Management and rehabilitation may be offered by your audiologist; or you may be referred to someone for additional tests or treatment that falls within another professional’s domain (for example, ENT or physiotherapist).
In summary, you should expect a detailed, multi-step evaluation involving history-taking, hearing assessment, eye and head movement tests, balance platform testing, and vestibular stimulation, all aimed at diagnosing the cause of your balance or dizziness issues.
Contact
Email: info@ican.org.za
WhatsApp: 0649155840
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