Dizziness/Balance Disorder

More than 2 million people visit the doctor each year with complaints of dizziness, vertigo, or motion sickness. Balance disorders are the number one health complaint of patients over the age of 70, and they are the cause of 50 percent of falls experienced by the elderly.

Your body maintains its balance, or equilibrium, through a complex relationship with many parts of the body, including the inner and middle ear. Less than ten percent of patients with balance and vestibular disorders are ever evaluated by a specialist. At The Comprehensive ENT Center of Texas, our highly trained audiologist, Dr. Spinuzza, uses state-of-the-art diagnostic tools to evaluate each patient and plan a customized course of treatment.

The most common balance complaint is peripheral vertigo. This is usually caused by inner ear inflammation from a cold or virus. Other common inner ear disorders that may elicit vertigo, dizziness, or disequilibrium include:

  • Benign Paroxysmal Positional Vertigo (BPPV) is caused by problems in the inner ear. This is most commonly caused by calcium particles that have broken off from otoliths, or stones, located in the utricle that has slipped into the semi-circular canals. Symptoms include repeated episodes of short-term vertigo, a spinning sensation that is provoked by a change in the position of the head.
  • Meniere’s Disease is an inner ear disorder that can affect both hearing and balance. It can cause episodes of vertigo, hearing loss, tinnitus, and the sensation of fullness in the ear. Labyrinthitis is an inflammation of the inner ear. It is usually caused by a virus, but it can also be caused by a bacterial infection.
  • Vestibular Neuronitis is an inflammation of the vestibular nerve that connects the inner ear to the brain.

If you are experiencing problems with your balance or you are feeling dizzy, VNG tests will help determine if a vestibular (inner ear) disease is the cause of your imbalance. The VNG test will evaluate nystagmus or involuntary rapid eye movement. Infrared goggles monitor and record eye movement at rest, after changes in head position and in response to various stimuli. Analysis of the pattern of eye movements during this test will help distinguish between abnormalities in the vestibular system, brainstem, and cerebellum.

doctor showing patient ear diagram

There are three parts to VNG testing:

  • Oculomotor Testing – These may indicate a central or neurological problem or a problem in the pathway connecting the vestibular system to the brain.
  • Positional/Positioning Nystagmus – This test examines your inner ear system and the condition of the endolymph fluid in your semicircular canals. Dr. Spinuzza will verify that small calcium particles, called otoconia, are not suspended in the fluid, causing a disturbance in the flow.
  • Caloric Study – This test assesses the function of the vestibular nerve for each ear by stimulating the ears with hot and cold air. This stimulation normally causes involuntary movements of both eyes (nystagmus). If the labyrinth is diseased, no nystagmus is induced. This test is the only test that can determine whether the vestibular deficit is unilateral or bilateral. Additionally, this test helps to differentiate between vestibular abnormalities and cerebellar or brainstem disorders.

Because hearing and balance functions of your inner ear are closely related, a hearing test will be administered before the VNG.

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