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Balance Tests

Balance Tests & Treatment

Having Issues With Balance Or Dizziness? Your Ears Could Be The Cause.

Audiologists are almost always the first place to go when you are feeling dizzy, because most often, dizziness starts with your ears.

Live Better Hearing + Balance is an American Institute of Balance Certified Center of Specialty Care. This means we use advanced clinical protocols with the most up-to-date technology to provide the most sophisticated level of care in the field of vestibular science.  In other words, we know how to help!

Dizziness can be a frustrating problem. When you come to our clinic our highly trained doctors of audiology will do a thorough evaluation to help pinpoint what is causing the problem.  Several different conditions can cause dizziness. The first step in assessing dizziness is to fully understand the patient’s medical history. So we will ask you some questions and then get into the balance testing that you need.

Questions the Audiologist Will Ask

The audiologist will take a full case history to understand when the dizziness occurs, how long it occurs, and if there are 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.

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.

The Examination

Here are a list of most of the types of testing we do:

Hearing Test

Your balance system is part of the ear. It’s essential to test both systems thoroughly when you have balance problems.

Rotary Chair Test

(Currently available in the Frederick, Maryland office, the Rockville, Maryland office, and soon to be in Bala Cynwyd, Pennsylvania.) The purpose of this test is to determine if the vestibular (inner ear) or the neurological system is the cause of a balance disorder. Very few clinics have the equipment for this test and it is the gold standard for gentle and effective vestibular testing.


This is a test of the lateral semicircular canals in the inner ear. This test can measure any differences between the ears. If there is a difference it could indicate conditions such as labyrinthitis, vestibular neuritis, or other forms of inner ear dysfunction. This test is crucial in diagnosing and understanding the root cause of dizziness, vertigo, or balance-related problems a patient may be experiencing. By accurately pinpointing the affected ear, it guides the course of treatment and management for optimal patient care.

Electrocochleography (EcoG)

This non-invasive test measures waveforms generated by the inner ear and auditory nerve in response to sound.

Vestibular-evoked myogenic potentials (VEMPs)

This non-invasive neurophysiological assessment technique is used to determine the function of the otolithic organs of the inner ear. It complements the information provided by caloric testing and other forms of inner ear testing. There are two different types of VEMPs. (oVEMP and cVEMP) We do both.

Auditory Brainstem Response (ABR)

This computerized test evaluates how well sounds travel along the hearing nerve pathways from the ear to the brainstem.

Videonystagmography (VNG)

This test measures eye movements and the muscles that control them.

Positional And Smooth Pursuit Testing

These balance tests measure how your eyes move in response to different positions, and shifting patterns on a screen.

Discover How Balance Tests Can Help You

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.

Common questions‍

What does a balance evaluation involve?

The audiologist will ask about the timing, triggers, and duration of dizziness, along with the patient's medical history including neurological, orthopedic, cardiovascular, respiratory, and vision conditions. They'll also discuss medication history, family history of motion sickness or migraines, and exposure to chemicals. Additionally, the audiologist will assess if the dizziness is constant or sporadic and if it relates to auditory symptoms such as tinnitus or sudden hearing changes.

What causes of dizziness do audiologists assess?

Audiologists evaluate conditions like Benign Paroxysmal Positional Vertigo (BPPV), Meniere’s disease, vestibular neuritis, labyrinthitis, and arteriosclerosis. BPPV involves dislodged inner ear crystals, Meniere’s disease causes severe vertigo episodes, vestibular neuritis and labyrinthitis are viral inner ear infections, and arteriosclerosis can lead to high blood pressure and reduced brain blood flow.

What balance tests are conducted at Live Better Hearing + Balance?

Our audiologists offer comprehensive evaluations including hearing tests, rotary chair tests, calorics, electrocochleography (EcoG), vestibular-evoked myogenic potentials (VEMPs), auditory brainstem response (ABR), videonystagmography (VNG), and positional and smooth pursuit testing.

How do balance tests aid in diagnosing and treating dizziness?

Balance tests assess inner ear and central nervous system function, determining the cause of balance disorders, measuring differences between ears, evaluating inner ear waveforms, auditory nerve responses, and otolithic organ functions. Based on results, audiologists decide if dizziness can be treated in-office or if a referral to another specialist is needed.

Peace of mind

Our Peace of Mind Coverage plans provide patients with an easy way to manage their hearing healthcare at Live Better Hearing. Hearing aids are both a financial and time investment, and annual service plans help to protect your investment.