Diagnosis of a balance disorder is complicated because there are many kinds of balance disorders and because other medical conditions--including ear infections, blood pressure changes, and some vision problems – and some medications may contribute to a balance disorder.
Your physicians at ENT Physicians will obtain a detailed medical history and perform a physical examination to start to sort out possible causes of the balance disorder. The physician may require tests to assess the cause and extent of the disruption of balance. The kinds of tests needed will vary based on the patient’s symptoms and health status and therefore not all patients will require every test.
Some examples of diagnostic tests your physician may request are a hearing examination, blood tests, audiology tests including a videonystagmogram (VNG), vestibular evoked myogenic potential (VEMP), electrocochleography and/or imaging studies of the head and brain.
VNG testing is used to determine if a vestibular (inner ear) disease may be causing a balance or dizziness problem, and is one of the only tests available today that can distinguish 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. 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. A caloric test may be performed as part of the VNG, in which each ear is irrigated with warm and then cool air, usually one ear at a time; the amount of nystagmus resulting is measured. Weak nystagmus or the absence of nystagmus may indicate an inner ear disorder.
The Vestibular Evoked Myogenic Potential test is recognized as an important tool in the routine vestibular test battery. Whereas traditional ENG/VNG test batteries may be used to assess the semicircular canals, the VEMP test is specifically for assessing the Saccule and associated Inferior Vestibular Nerve function, which may assist in explaining the cause for your dizziness and/or balance disorder.
An additional procedure to assist in obtaining a diagnosis is an electrocochleography. An electrocochleography is an inner ear test involving the use of sound stimulation to provide electrical measurements which can be used to assist in the diagnosis of Méniére's disease.