How are Vestibular Disorders Diagnosed?

Doctors use information from a person’s medical history and findings from a physical examination as a basis for ordering diagnostic tests to assess the vestibular system function to rule out alternative causes of symptoms.

TESTING VESTIBULAR DYSFUNCTION

The vestibular and visual systems are connected to each other and to the muscles in the eyes and neck that help maintain good balance.  Head movements or other stimulation of the inner ear sends signals through the nervous system to control eye muscle movements.  This forms a reflex pathway called the vestibule-ocular reflex, or VOR.  This system is designed to generate eye movements that maintain clear vision when the head is in motion.  Many vestibular tests use equipment to monitor the eyes for normal and abnormal movements when the vestibular system is stimulated.

  • Electro/Video-Nystagmography (ENG or VNG)

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  • Rotation Tests

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  • Video Head Impulse Testing (VHIT)

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  • Vestibular Evoked Myogenic Potential (VEMP)

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  • Computerized Dynamic Postugraphy (CDP)

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 AUDIOMETRY (HEARING TESTS)

Audiometry measures hearing function.  Hearing evaluations are an important part of vestibular diagnostics, because the inner ear contains both hearing and balance organs.

  • Pure Tone Audiogram
  • Speech Audiogram
  • Immitance testing (Tympanogram and Acoustic Reflexes)
  • Oto-Acoustic Emissions (OAE)
  • Electrocochleography (ECOG)
  • Auditory Brainstem Response Test (ABR)

 

MAGNETIC RESONANCE IMAGING (MRI)

An MRI of the brain can reveal the presence of tumours, stroke damage, and other soft-tissue abnormalities that might cause dizziness or vertigo. MRIs of structures in and around the inner ear can be helpful in the diagnosis of some vestibular disorders.

 

COMPUTERIZED AXIAL TOMOGRAPHY (CAT OR CT)

A CT scan is an X-ray technique that is best for studying bony structures.  The inner ear is inside of the skull’s temporal bone on each side.  These scans are often used to look for abnormalities around the inner ear, such as fractures or areas with thinning bone.

WHO PERFORMS VESTIBULAR TESTING?

  • An Audiologist for hearing and balance related testing.
  • Physio Therapist for gait or balance related testing.
  • A Radiologist for imaging testing.

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