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Balance Evaluation and Treatment

Our audiologists at Live Better Hearing + Balance play a crucial role in the assessment and treatment of dizzy patients in our communities. We have specialized equipment, including rotary chairs, VNGs, calorics, and EcoGs, which allow us to evaluate dizziness problems in a highly scientific way.

Our expert clinicians are trained to determine relatively quickly whether a patient’s problem with dizziness can be treated in the office or needs to be referred to a different specialist. In most cases, the audiologist is the first step on the pathway to feeling better.

How it works

Dizziness can be a difficult complaint to evaluate because it can be a hard sensation to measure. Several different physiological conditions can cause dizziness. The first step in assessing a patient’s complaint of dizziness is to fully understand the patient’s medical history.

balance ear dizziness

The audiologist will take a full case history to understand when the dizziness occurs, how long it occurs, and if there any triggers that precipitate the feeling of it.

Other important considerations include if the patient has had any neurologic, orthopedic, cardiovascular, respiratory, vision, or other health conditions. Medications are also an important factor when evaluating the problem since medicines can either cause dizziness or temporarily suppress it, masking the underlying symptom.

Our clinicians will ask the patient about a family history of motion sickness, migraines, and exposure to chemicals. The clinician will also want to know if the dizziness is constant or if it is sporadic. Does the dizziness relate to the patient’s body position? For example, if the patient tilts his/her head backward or forward does that cause the dizziness to start? Other considerations include if the patient has difficulty hearing or if there are any noises in the ears (tinnitus) or sudden hearing changes. Even a stuffy nose could potentially be a cause for consideration.

Why dizziness happens

Our bodies maintain balance with sensory information from three systems: vision proprioception ( muscles and joints) and vestibular (inner ear). Input from these systems is integrated and processed by the brain. If there is damage or impairment of any kind to these systems dizziness vertigo and imbalance may occur. Vertigo is the perception of spinning. Dizziness is a general term of lightheadedness or floating sensation. And imbalance is a feeling of being off balance or a loss of equilibrium.

The two main types of dizziness

Our audiologists will work toward understanding if the dizziness is vestibular or non-vestibular.

Vestibular dizziness is usually described as a sensation of spinning. Patients with this disorder may report that they feel like their eyes are moving around back and forth when they are closed. This sensation is called nystagmus.

Vertigo is usually a vestibular dizziness. And true vertigo only happens in episodes. Sometimes those episodes are as short as a minute, and sometimes they are as long as days. The causes of vertigo usually originate in the ear, although it can also be caused by the brain. Dizziness that is caused by the ear is called peripheral vertigo. Vertigo that is caused by the brain is called central vertigo. With central vertigo, there are, frequently other neurological symptoms that will go along with it. These types of symptoms might include things like numbness, weakness, or general clumsiness. With peripheral vertigo, there may be symptoms like ringing in the ear or hearing loss as well as nausea and vomiting.

Vertigo is often worsened by head movements, whereas patients with non-vestibular dizziness are more inclined to say that moves in their visual field cause problems.

Dizziness can be related to changes in posture or body position. Sometimes they can be associated with symptoms like nausea and vomiting. In these cases, they are more likely to be related to vestibular causes of dizziness.

Non-vestibular dizziness is usually a general feeling of imbalance or the sensation of something moving inside the head. Patients with known non-vestibular dizziness do not have nystagmus. They often have a sense of motion sickness or feel like they are leaning to one side or about to fall. Sometimes these patients will describe their symptoms with words like floating or lightheadedness. Some patients can also have psychophysiological dizziness. This is the feeling where the patient feels like they left their body.

Common conditions that cause dizziness

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of dizziness. This condition happens when small crystals in the inner ear become dislodged. Our audiologists can fix this through a noninvasive procedure called the Epley maneuver. Other common causes of dizziness include Meniere’s disease, which is often responsible for severe episodes of vertigo that last for several hours, vestibular neuritis or labyrinthitis, which are usually viral infections of the inner ear and can cause sudden or prolonged vertigo hearing loss and tinnitus. Even conditions like arteriosclerosis, which is the buildup of fatty deposits in the arteries can cause dizziness because it can create high blood pressure and reduce blood flow to the brain. These are just a few of the many conditions that we evaluate for at our clinics.

What we do to help

Our audiologists offer safe and comfortable balance evaluations. If you feel woozy, imbalanced, or the sensation of spinning, our audiologists will do special hearing tests and eye-movement tests to evaluate your inner ear function as well as your central nervous system function.

Our clinicians care about improving the lives and well-being of our patients. That’s why we provide the gold standard in balance testing. We partner with top specialists in otology, neurotology, physical therapy, psychology, and other related fields to get the best possible outcomes for every patient.

balance testing audiologist