Materiały źródłowe

• #1 Balance disorder – Wikipedia

  https://en.wikipedia.org/wiki/Balance_disorder

  A balance disorder is a disturbance that causes an individual to feel unsteady, for example when standing or walking. […] Problems with balance can occur when there is a disruption in any of the vestibular, visual, or proprioceptive systems. […] The difficulty of making the right vestibular diagnosis is reflected in the fact that in some populations, more than one-third of the patients with a vestibular disease consult more than one physician in some cases up to more than fifteen. […] Scientists at the National Institute on Deafness and Other Communication Disorders (NIDCD) are working to understand the various balance disorders and the complex interactions between the labyrinth, other balance-sensing organs, and the brain. […] NIDCD scientists are studying eye movement to understand the changes that occur in aging, disease, and injury, as well as collecting data about eye movement and posture to improve diagnosis and treatment of balance disorders.

• #2 Dizziness: A Diagnostic Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0815/p361.html

  Dizziness accounts for an estimated 5 percent of primary care clinic visits. The patient history can generally classify dizziness into one of four categories: vertigo, disequilibrium, presyncope, or lightheadedness. […] The differential diagnosis of dizziness can be narrowed with easy-to-perform physical examination tests, including evaluation for nystagmus, the Dix-Hallpike maneuver, and orthostatic blood pressure testing. Laboratory testing and radiography play little role in diagnosis. A final diagnosis is not obtained in about 20 percent of cases. […] Diagnosing the cause of dizziness can be difficult because symptoms are often nonspecific and the differential diagnosis is broad. However, a few simple questions and physical examination tests can help narrow the possible diagnoses. […] Although appropriate history and physical examination usually leads to a diagnosis, the final cause of dizziness is not identified in up to one in five patients.

• #3 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Balance-Disorder-Diagnosis.aspx

  There are several disorders that may lead to balance problems. Diagnosis aims at detecting the cause of balance problems. Balance problems thus are symptoms of an underlying condition rather than a disease in itself. […] The cause of balance problems may vary between ear infections, blood pressure changes, vision problems or even medications that may cause balance problems. […] Steps in diagnosis of the conditions include:- Complete evaluation of the problem with history of onset, duration of the balance disorders and family history. […] A precipitating ear infection, vision problem or head injury or a history of intake of a balance problem causing medication is often found upon enquiring the history from the patient. This may provide valuable clues in diagnosing balance problems. […] Evaluation and diagnosis may be made by a primary physician who may then request the opinion or refer to an otolaryngologist to help evaluate a balance problem. An otolaryngologist or ENT surgeon is a physician/surgeon who specializes in diseases and disorders of the ear, nose, throat, head, and neck.

• #4 Dizziness: Approach to Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0201/p154.html

  Dizziness is a common yet imprecise symptom. […] Evaluation focuses on determining whether the etiology is peripheral or central. Peripheral etiologies are usually benign. Central etiologies often require urgent treatment. The HINTS (head-impulse, nystagmus, test of skew) examination can help distinguish peripheral from central etiologies. […] TiTrATE is a novel diagnostic approach to determine the probable etiology of dizziness or vertigo. It uses the Timing of the symptom, the Triggers that provoke the symptom, And a Targeted Examination. The patient’s response determines the classification of dizziness as episodic triggered, spontaneous episodic, or continuous vestibular. […] The HINTS (head-impulse, nystagmus, test of skew) examination can help differentiate a peripheral cause of vestibular neuritis from a central cause.

• #5 Dizziness: Approach to Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0201/p154.html

  Dizziness is a common yet imprecise symptom. […] Evaluation focuses on determining whether the etiology is peripheral or central. Peripheral etiologies are usually benign. Central etiologies often require urgent treatment. The HINTS (head-impulse, nystagmus, test of skew) examination can help distinguish peripheral from central etiologies. […] TiTrATE is a novel diagnostic approach to determine the probable etiology of dizziness or vertigo. It uses the Timing of the symptom, the Triggers that provoke the symptom, And a Targeted Examination. The patient’s response determines the classification of dizziness as episodic triggered, spontaneous episodic, or continuous vestibular. […] The HINTS (head-impulse, nystagmus, test of skew) examination can help differentiate a peripheral cause of vestibular neuritis from a central cause.

• #6 Dizziness: Approach to Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0201/p154.html

  The use of the HINTS (head-impulse, nystagmus, test of skew) examination can help distinguish a possible stroke (central cause) from acute vestibular syndrome (peripheral cause). […] The diagnostic criteria for Meniere disease include episodic vertigo (at least two episodes lasting at least 20 minutes) associated with documented low- to medium-frequency sensorineural hearing loss by audiometric testing in the affected ear and tinnitus or aural fullness in the affected ear. […] The HINTS examination is highly sensitive and specific in identifying stroke in patients with acute vestibular syndrome, and it is superior to diffusion-weighted magnetic resonance imaging in ruling out stroke.

• #7 Balance Disorders — Causes, Types & Treatment | NIDCD

  https://www.nidcd.nih.gov/health/balance-disorders

  How are balance disorders diagnosed? […] Diagnosis of a balance disorder is difficult. To find out if you have a balance problem, your primary doctor may suggest that you see an otolaryngologist and an audiologist. An otolaryngologist is a physician and surgeon who specializes in diseases and disorders of the ear, nose, neck, and throat. An audiologist is a clinician who specializes in the function of the hearing and vestibular systems. […] You may be asked to participate in a hearing examination, blood tests, a video nystagmogram (a test that measures eye movements and the muscles that control them), or imaging studies of your head and brain. Another possible test is called posturography. For this test, you stand on a special movable platform in front of a patterned screen. […] Posturography measures how well you can maintain steady balance during different platform conditions, such as standing on an unfixed, movable surface. Other tests, such as rotational chair testing, brisk head-shaking testing, or even tests that measure eye or neck muscle responses to brief clicks of sound, may also be performed. The vestibular system is complex, so multiple tests may be needed to best evaluate the cause of your balance problem.

• #8 Balance Disorders – ENT Diseases and Conditions l Riverside Health l Southeastern VA

  https://www.riversideonline.com/en/medical-services/ear-nose-and-throat/diseases-and-conditions/balance-disorders

  If you feel unsteady or dizzy, as if you are moving, spinning, or floating, even though you are standing still or lying down, you may have a balance disorder. […] Diagnosis of a balance disorder is difficult. Our sense of balance is primarily controlled by a maze-like structure in our inner ear. There are many potential causes of balance issues including medical conditions and medications. […] To help evaluate a balance problem, your doctor may suggest you see a Riverside otolaryngologist, a physician and surgeon who specializes in the ear, nose, and throat. Your otolaryngologist may request tests including: […] A hearing examination […] An electronystagmogram. Your doctor will measure your eye movements and the muscles that control them. […] Imaging studies of your head and brain, such as a CT scan or MRI. […] A posturography. You’ll stand on a movable platform in front of a patterned screen. The doctor measures how your body moves in response to movement of the platform, the patterned screen, or both. […] Blood tests.

• #9 Diagnosis and Tests for Balance Problems | American Geriatrics Society | HealthInAging.org

  https://www.healthinaging.org/a-z-topic/balance-problems/tests

  If a person has balance problems, their healthcare professional will take a medical history and do a physical exam to diagnose the source of the problem. […] Your healthcare professional may recommend seeing a specialist depending on the suspected source of the balance problems: […] In rare cases, the healthcare professional may order further tests, which are simple and painless. For example, imaging tests, like the magnetic resonance imaging (MRI) or computerized tomography (CT scan). […] These tests can help find out if the problem is in the inner ear or there is a different cause.

• #10 Which Medical Specialists Test and Treat Balance Disorder – Hearing & Balance Services of Reston

  https://balancehear.com/which-medical-specialists-test-and-treat-balance-disorder/

  You may not give your ability to stand much thought until you have problems with dizziness and vertigo. […] When this happens more than you’re comfortable with, you have a balance disorder. […] Your journey for treatment of balance disorder may start at an audiologist like Hearing Balance Services of Reston. […] Since a problem in any of these areas can be responsible for balance disorders, you may need to see other medical specialists to resolve your balance issues. […] Testing and treatment for balance disorders usually starts with a visit to the audiologist. […] With ear health confirmed, you may need to follow up with other specialists if your balance disorder continues. […] A neurologist may become part of your team if ear function is fine. […] Your sense of balance is the result of a complex system and process, so it follows that testing and treatment of difficult cases can be equally complex.

• #11 Balance Disorders (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/balance-disorders.html

  To look for a balance problem, the doctor will ask about symptoms and do an exam, including watching a child walk, checking their balance, and testing their motor skills. […] The doctor might want the child to see an audiologist (a hearing and balance specialist), an otolaryngologist (an ear, nose, and throat specialist, or ENT), a physical therapist, and/or a neurologist (a brain and nervous system specialist). […] Tests done to look for a problem can include: imaging tests, like an MRI or a CT scan, hearing tests to check hearing sensitivity and middle ear functioning, electronystagmogram (ENG) to assess balance using electrodes placed around the eyes while a computer monitors involuntary eye movements, videonystagmography (VNG), in which the child wears special video recording goggles to measure eye movement while they focus on various targets, vestibular evoked myogenic potential (VEMP), which uses electrodes on the head and neck to measure muscle contractions (cervical) and eye movements (ocular) in response to loud clicks, video head impulse test (vHIT), which uses special goggles to check parts of the inner ear as the head is moved in different directions, rotary chair testing, which uses goggles and a special chair to assess vestibular function for differences between the two ears, posturography, which measures the ability to balance while standing on a stable or unstable platform, balance questionnaires for kids who can describe their level of dizziness throughout the day while doing different things. […] Diagnosing and treating balance disorders early can help kids become steadier and more coordinated, do the things they like, and feel better.

• #12 Diagnosis and Tests for Dizziness | American Geriatrics Society | HealthInAging.org

  https://www.healthinaging.org/a-z-topic/dizziness/tests

  The healthcare professional will ask about your medical history. They will also do a physical exam to identify the source of your dizziness. […] Your health care provider will discuss your medical conditions, to figure out which one(s) can cause dizziness. […] When you have dizziness, ask your healthcare professional to assess your risk of falling. They can recommend dietary changes, exercises, and assistive devices to improve your stability and lower your risk of falling. […] Depending on the cause of the dizziness, a specialist may be involved: […] a cardiologist if irregular heartbeats contribute to balance issues.

• #13 Diagnostic Tests – Balance & Dizziness Canada

  https://balanceanddizziness.org/diagnosis-and-treatment/diagnostic-tests/

  More comprehensive vestibular function testing is offered at a number of locations in across Canada. […] A full assessment of the vestibular system can take up to 3 or 4 hours and may be done over several appointments. […] The majority of the diagnostic tests cause little or no dizziness. One portion, however, induces temporary dizziness and sometimes nausea. […] There is nothing wrong with all of the tests being normal; do not fight normal results. Normal results are helpful and do not mean that the doctor will not believe something is wrong. […] Although new tests can reveal how your balance system is able to reference gravity, current testing is not sensitive enough to pick up some problems coming from some parts of the balance system. A normal set of tests does not rule out a problem.

• #14 Dizziness (Vertigo) and Balance Problems: Diagnostic Tests | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/dizziness-vertigo-and-balance-problems-diagnostic-tests

  An otolaryngologist specializes in problems of the ear, nose, and throat. If you are having vertigo or balance problems, your primary care provider may send you to an ENT to help with a diagnosis. You’ll be sent for hearing testing. This is because the nerve that sends balance signals also sends hearing signals. A problem that affects balance can also affect hearing. Your ENT may advise other tests. These tests don’t cause pain, but they may make you dizzy in some cases. […] Rotational chair testing provides additional information to audiologists regarding the origin of vertigo whether it is peripheral or central. […] This tests your standing balance under different conditions. […] An abnormal ECoG may mean you have Meniere’s disease or other health problems. […] This test may be used if your ENT suspects a rare condition like superior semicircular canal dehiscence. This is a hole in the bone that covers the part of the inner ear where fluid circulates and regulates balance.

• #15 Diagnostic Tests – Balance & Dizziness Canada

  https://balanceanddizziness.org/diagnosis-and-treatment/diagnostic-tests/

  Diagnostic Tests for Balance and Dizziness Disorders […] Hearing tests […] Balance tests […] Vestibular function tests […] Based on your history and physical findings, your doctor may order other tests including a CT scan (computerized tomography), MRI scan (magnetic resonance imaging) or ultrasound and ECG (electrocardiogram) as well as blood and neurological tests to rule out a more serious or life-threatening condition. You may also have some of the following tests to see how well different parts of your balance system are functioning. […] The resulting test patterns can potentially reveal problems with the balance system. A normal hearing test is in itself informative. […] The GANS Sensory Organizational Performance (SOP) test and Computerized Dynamic Posturography (CDP) are different ways of assessing overall patterns of balance performance under different conditions. Some diagnostic centres use the GANS SOP test and others use CDP.

• #16 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Balance-Disorder-Diagnosis.aspx

  Physical examination the next step is to obtain a detailed physical examination. The general health is examined that includes blood pressure and blood sugar evaluations, fluctuations of which may lead to balance problems or dizziness and falls. The ears are examined for abnormalities, hearing difficulties and infections if any. […] An electronystagmogram (ENG) is often advised. This test checks for abnormalities of the vestibular system. The caloric test may be performed as part of the ENG. […] For this test each ear is flushed with warm and then cold water one at a time. When water is flushed, the eyes move rapidly from side to side. This is called nystagmus. The amount of nystagmus resulting from the test is measured. Weak nystagmus or the absence of nystagmus may indicate an inner ear disorder.

• #17 Diagnostic Testing – National Dizzy & Balance Center

  https://www.nationaldizzyandbalancecenter.com/resources/diagnostic-testing/

  The human body uses three sensory inputs to maintain proper balance. They are: Touch (feet, ankles, joints), Sight (eyes), and Vestibular (inner ear system). These sensory inputs interact with the brain, which then drive and control our motor functions. Because of the complexity of the balance system, diagnosing a dizziness or balance problem and its specific cause can be difficult. The good news is that there are a number of diagnostic tests that can be performed to more accurately determine the source of your dizziness or balance problem. […] These are the common types of diagnostic testing performed for dizziness and balance disorders: […] Videonystagmography (VNG) This is the most common diagnostic test administered to patients with dizziness and/or balance disorders. It is a battery of tests that records quantitative measurements of nystagmus using infrared goggles and provides objective documentation of vestibular function. This is also currently the one of the only tests available to decipher between a bilateral (both ears) and unilateral (one ear) weakness, the other being Rotational Chair below.

• #18 Dizziness (Vertigo) and Balance Problems: Diagnostic Tests | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/dizziness-vertigo-and-balance-problems-diagnostic-tests

  An otolaryngologist specializes in problems of the ear, nose, and throat. If you are having vertigo or balance problems, your primary care provider may send you to an ENT to help with a diagnosis. You’ll be sent for hearing testing. This is because the nerve that sends balance signals also sends hearing signals. A problem that affects balance can also affect hearing. Your ENT may advise other tests. These tests don’t cause pain, but they may make you dizzy in some cases. […] Rotational chair testing provides additional information to audiologists regarding the origin of vertigo whether it is peripheral or central. […] This tests your standing balance under different conditions. […] An abnormal ECoG may mean you have Meniere’s disease or other health problems. […] This test may be used if your ENT suspects a rare condition like superior semicircular canal dehiscence. This is a hole in the bone that covers the part of the inner ear where fluid circulates and regulates balance.

• #19 Dizziness (Vertigo) and Balance Problems: Diagnostic Tests

  https://healthlibrary.somc.org/Library/DiseasesConditions/Pediatric/Growth/3,85843

  MRI scan. This test makes detailed images of the ear or head. A magnetic field and contrast medium are used to make the image. […] Electronystagmography (ENG). This test records eye movement. Small electrodes are put on the skin around your eyes. Then your ear is filled with warm or cold water. This normally causes the eyes to move rapidly in one direction (nystagmus). […] Rotation tests. Rotational chair testing provides additional information to audiologists regarding the origin of vertigo whether it is peripheral or central. For this test you sit in a chair that revolves slowly and your eye movements are recorded by special goggles that you wear. Audiologists examine your eye movements to see how they relate to your inner ear health. […] Posturography. This tests your standing balance under different conditions. You’ll stand on a platform. It measures shifts in your body weight.

• #20 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Balance-Disorder-Diagnosis.aspx

  Another test for vestibular health is called posturography. The patient is asked to stand on a special platform capable of movement within a controlled visual environment. The sway of the body in response to movement and visual environment is recorded. […] Blood tests for detection of abnormalities like anemia, high or low blood sugar are advised. Usually a complete blood count, thyroid function test, liver and kidney function tests, electrolytes, blood urea nitrogen, creatinine, glucose, and vitamin B12 levels are tested. […] Imaging studies of the head including CT scan (Computed Tomography scan) or MRI scan (Magnetic resonance imaging scan) are performed to check for injuries and abnormalities in the brain and cerebellum part of the brain that controls balance and coordination.

• #21 Diagnostic Testing – National Dizzy & Balance Center

  https://www.nationaldizzyandbalancecenter.com/resources/diagnostic-testing/

  Rotational Chair Testing The purpose of rotational chair testing is to determine whether or not dizziness may be due to a disorder of inner ear or brain. This tests measures the dizziness (nystagmus) while slowly being turned in a chair that rotates back and forth. Rotary chair tests are usually ordered in addition to ENG/VNG (caloric) testing to confirm a diagnosis and increase accuracy. […] Computerized Dynamic Posturography (CDP) This tests the relationships among all the parts of a patients balance systemeyes, somatosensory system, and vestibular system. The patient stands on a platform surrounded on three sides by a colored screen. His or her stability is first measured using all three inputs. Then, the patient is tested with one or more of the three inputs either reduced or eliminated. For example, the patient stands with eyes closed to eliminate the visual input. The platform and/or the screen may also move slightly during the testing.

• #22 Dizziness (Vertigo) and Balance Problems: Diagnostic Tests | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/dizziness-vertigo-and-balance-problems-diagnostic-tests

  An otolaryngologist specializes in problems of the ear, nose, and throat. If you are having vertigo or balance problems, your primary care provider may send you to an ENT to help with a diagnosis. You’ll be sent for hearing testing. This is because the nerve that sends balance signals also sends hearing signals. A problem that affects balance can also affect hearing. Your ENT may advise other tests. These tests don’t cause pain, but they may make you dizzy in some cases. […] Rotational chair testing provides additional information to audiologists regarding the origin of vertigo whether it is peripheral or central. […] This tests your standing balance under different conditions. […] An abnormal ECoG may mean you have Meniere’s disease or other health problems. […] This test may be used if your ENT suspects a rare condition like superior semicircular canal dehiscence. This is a hole in the bone that covers the part of the inner ear where fluid circulates and regulates balance.

• #23 Diagnostic Tests – Balance & Dizziness Canada

  https://balanceanddizziness.org/diagnosis-and-treatment/diagnostic-tests/

  There are pathways that go from the otolith organs (utricle and saccule) in the inner ear to different muscle sets. These pathways stimulate responses that can be measured on the muscles. […] Currently, 2 types of muscle tests can be done to assess the utricle and saccule: […] cVEMP (Cervical Vestibular Evoked Myogenic Potential) test The cVEMP test uses the muscles in the neck to record a response from one of the balance system structures called the saccule. […] oVEMP (Ocular Vestibular Evoked Myogenic Potential) test The oVEMP test engages a little eye muscle around and under each eye. […] vHIT (Video Head Impulse Test) One of the jobs of the balance system is to stabilize the eyes. […] Patients put on special goggles that record eye movements when the head is moved quickly.

• #24 Diagnostic Tests – Balance & Dizziness Canada

  https://balanceanddizziness.org/diagnosis-and-treatment/diagnostic-tests/

  There are pathways that go from the otolith organs (utricle and saccule) in the inner ear to different muscle sets. These pathways stimulate responses that can be measured on the muscles. […] Currently, 2 types of muscle tests can be done to assess the utricle and saccule: […] cVEMP (Cervical Vestibular Evoked Myogenic Potential) test The cVEMP test uses the muscles in the neck to record a response from one of the balance system structures called the saccule. […] oVEMP (Ocular Vestibular Evoked Myogenic Potential) test The oVEMP test engages a little eye muscle around and under each eye. […] vHIT (Video Head Impulse Test) One of the jobs of the balance system is to stabilize the eyes. […] Patients put on special goggles that record eye movements when the head is moved quickly.

• #25 Diagnostic Tests – Balance & Dizziness Canada

  https://balanceanddizziness.org/diagnosis-and-treatment/diagnostic-tests/

  There are pathways that go from the otolith organs (utricle and saccule) in the inner ear to different muscle sets. These pathways stimulate responses that can be measured on the muscles. […] Currently, 2 types of muscle tests can be done to assess the utricle and saccule: […] cVEMP (Cervical Vestibular Evoked Myogenic Potential) test The cVEMP test uses the muscles in the neck to record a response from one of the balance system structures called the saccule. […] oVEMP (Ocular Vestibular Evoked Myogenic Potential) test The oVEMP test engages a little eye muscle around and under each eye. […] vHIT (Video Head Impulse Test) One of the jobs of the balance system is to stabilize the eyes. […] Patients put on special goggles that record eye movements when the head is moved quickly.

• #26 Diagnostic Tests – Balance & Dizziness Canada

  https://balanceanddizziness.org/diagnosis-and-treatment/diagnostic-tests/

  There are pathways that go from the otolith organs (utricle and saccule) in the inner ear to different muscle sets. These pathways stimulate responses that can be measured on the muscles. […] Currently, 2 types of muscle tests can be done to assess the utricle and saccule: […] cVEMP (Cervical Vestibular Evoked Myogenic Potential) test The cVEMP test uses the muscles in the neck to record a response from one of the balance system structures called the saccule. […] oVEMP (Ocular Vestibular Evoked Myogenic Potential) test The oVEMP test engages a little eye muscle around and under each eye. […] vHIT (Video Head Impulse Test) One of the jobs of the balance system is to stabilize the eyes. […] Patients put on special goggles that record eye movements when the head is moved quickly.

• #27 Diagnostic Tests – Balance & Dizziness Canada

  https://balanceanddizziness.org/diagnosis-and-treatment/diagnostic-tests/

  VNG (Videonystagmography) tests VNG tests involve wearing goggles fitted with infrared cameras that record eye movements. […] Dynamic visual acuity (DVA) test A primary function of the vestibular system is to maintain the stability of your eyes while your head is in motion. […] This useful test is done routinely to help measure change in the vestibular ocular reflex (VOR) after vestibular rehabilitation. […] Subjective Visual Vertical (SVV) Test This test evaluates one of the inner ear organs responsible for sensing gravity (utricle). […] This test has been found to be useful for patients with vestibular neuritis, injury to the inner ear, or injury to the nerve that transmits information from the inner ear to the brain.

• #28 Balance Disorders – ENT Diseases and Conditions l Riverside Health l Southeastern VA

  https://www.riversideonline.com/en/medical-services/ear-nose-and-throat/diseases-and-conditions/balance-disorders

  If you feel unsteady or dizzy, as if you are moving, spinning, or floating, even though you are standing still or lying down, you may have a balance disorder. […] Diagnosis of a balance disorder is difficult. Our sense of balance is primarily controlled by a maze-like structure in our inner ear. There are many potential causes of balance issues including medical conditions and medications. […] To help evaluate a balance problem, your doctor may suggest you see a Riverside otolaryngologist, a physician and surgeon who specializes in the ear, nose, and throat. Your otolaryngologist may request tests including: […] A hearing examination […] An electronystagmogram. Your doctor will measure your eye movements and the muscles that control them. […] Imaging studies of your head and brain, such as a CT scan or MRI. […] A posturography. You’ll stand on a movable platform in front of a patterned screen. The doctor measures how your body moves in response to movement of the platform, the patterned screen, or both. […] Blood tests.

• #29 Diagnostic Tests – Balance & Dizziness Canada

  https://balanceanddizziness.org/diagnosis-and-treatment/diagnostic-tests/

  Diagnostic Tests for Balance and Dizziness Disorders […] Hearing tests […] Balance tests […] Vestibular function tests […] Based on your history and physical findings, your doctor may order other tests including a CT scan (computerized tomography), MRI scan (magnetic resonance imaging) or ultrasound and ECG (electrocardiogram) as well as blood and neurological tests to rule out a more serious or life-threatening condition. You may also have some of the following tests to see how well different parts of your balance system are functioning. […] The resulting test patterns can potentially reveal problems with the balance system. A normal hearing test is in itself informative. […] The GANS Sensory Organizational Performance (SOP) test and Computerized Dynamic Posturography (CDP) are different ways of assessing overall patterns of balance performance under different conditions. Some diagnostic centres use the GANS SOP test and others use CDP.

• #30 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Balance-Disorder-Diagnosis.aspx

  Another test for vestibular health is called posturography. The patient is asked to stand on a special platform capable of movement within a controlled visual environment. The sway of the body in response to movement and visual environment is recorded. […] Blood tests for detection of abnormalities like anemia, high or low blood sugar are advised. Usually a complete blood count, thyroid function test, liver and kidney function tests, electrolytes, blood urea nitrogen, creatinine, glucose, and vitamin B12 levels are tested. […] Imaging studies of the head including CT scan (Computed Tomography scan) or MRI scan (Magnetic resonance imaging scan) are performed to check for injuries and abnormalities in the brain and cerebellum part of the brain that controls balance and coordination.

• #31 Dizziness (Vertigo) and Balance Problems: Diagnostic Tests | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/dizziness-vertigo-and-balance-problems-diagnostic-tests

  Your blood pressure can be taken both while you’re sitting and after you stand for 2 to 3 minutes to see if there are any noticeable drops. Your heart rate may be tracked while you are upright. This is done to help determine whether your symptoms are related to a fall in blood pressure or a heart issue.

• #32 Balance System Disorders

  https://www.asha.org/practice-portal/clinical-topics/balance-system-disorders/?srsltid=AfmBOoqNOq4h_vlL3ZH27trVR01boZhRXy5gECajqyiMO_bI3VW3q7Mn

  Causes of balance system disorders may include, but not be limited to, acute injury to the vestibular system, aging vestibular system, alcohol and/or drug ingestion, benign paroxysmal positional vertigo (BPPV), and Mnires disease. […] Audiologists play a role in the screening, assessment, diagnosis, and management of persons with balance system disorders, often as part of an interprofessional collaborative team. […] The assessment of a patient with dizziness and/or imbalance complaints includes aspects of the central and peripheral vestibular system as well as sensory and motor balance components. […] Accurate differential diagnosis of balance system disorders relies partly on the audiologists interpretation of a test battery within the context of the individuals medical history. […] Management of balance and vestibular disorders may include medical, surgical, and/or rehabilitative approaches. […] Canalith repositioning procedures (CRPs) are maneuvers used in the management of benign paroxysmal positional vertigo (BPPV).

• #33 Diagnostic Tests – Balance & Dizziness Canada

  https://balanceanddizziness.org/diagnosis-and-treatment/diagnostic-tests/

  Although no test of balance performance can provide a specific diagnosis, there are patterns of results that can be correlated with other vestibular tests and may indicate different types of balance disorders. […] Clinical tests of vestibular function assess whether there are problems with the balance structures of the inner ear (vestibular system) and/or their connections with our eyes, central nervous system and the proprioceptive system (sense of self movement and body position). […] The balance system consists of 5 sensors in each ear – 3 fluid-filled semicircular canals and 2 otolith organs (utricle and saccule). There are tests to assess all 10 of these sensors. […] Family and emergency doctors, vestibular therapists, and some audiologists routinely do the Dix-Hallpike and/or roll tests for benign paroxysmal positional vertigo (BPPV). These are positional tests that figure out whether your dizziness is triggered or made worse by certain head movements.

• #34 Diagnostic Tests – Balance & Dizziness Canada

  https://balanceanddizziness.org/diagnosis-and-treatment/diagnostic-tests/

  More comprehensive vestibular function testing is offered at a number of locations in across Canada. […] A full assessment of the vestibular system can take up to 3 or 4 hours and may be done over several appointments. […] The majority of the diagnostic tests cause little or no dizziness. One portion, however, induces temporary dizziness and sometimes nausea. […] There is nothing wrong with all of the tests being normal; do not fight normal results. Normal results are helpful and do not mean that the doctor will not believe something is wrong. […] Although new tests can reveal how your balance system is able to reference gravity, current testing is not sensitive enough to pick up some problems coming from some parts of the balance system. A normal set of tests does not rule out a problem.

• #35 Evaluation of balance disorders – Differential diagnosis of symptoms | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/711

  Balance disorders are common and may significantly impact upon quality of life and independence. Impaired balance may result in falls with resulting morbidity and mortality, particularly in older people. […] Symptoms of dizziness or vertigo may constitute between 1% and 15.5% of primary care consultations. […] Among the most commonly reported etiologies in primary care are vestibular/peripheral (5.4% to 42.1%), benign paroxysmal positional vertigo (4.3% to 39.5%), cardiovascular disease (3.8% to 56.8%), psychogenic (1.8% to 21.6%), Meniere disease (1.4% to 2.7%), neurologic disease (1.4% to 11.4%) vestibular neuritis (0.6% to 24%), and no clear diagnosis (up to 80.2%).

• #36 Dizziness: Approach to Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0201/p154.html

  The use of the HINTS (head-impulse, nystagmus, test of skew) examination can help distinguish a possible stroke (central cause) from acute vestibular syndrome (peripheral cause). […] The diagnostic criteria for Meniere disease include episodic vertigo (at least two episodes lasting at least 20 minutes) associated with documented low- to medium-frequency sensorineural hearing loss by audiometric testing in the affected ear and tinnitus or aural fullness in the affected ear. […] The HINTS examination is highly sensitive and specific in identifying stroke in patients with acute vestibular syndrome, and it is superior to diffusion-weighted magnetic resonance imaging in ruling out stroke.

• #37 What Is Ménière’s Disease? — Diagnosis and Treatment

  https://www.nidcd.nih.gov/health/menieres-disease

  Mnires disease is a disorder of the inner ear that causes severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or congestion in the ear. […] Mnires disease is most often diagnosed and treated by an otolaryngologist (commonly called an ear, nose, and throat doctor, or ENT). […] Although the causes of Mnires disease remain unclear, the symptoms of Mnires disease are associated with a fluid imbalance in a part of the inner ear called the labyrinth. […] In people with Mnires disease, a buildup of endolymph in the labyrinth called endolymphatic hydrops disrupts normal balance and hearing signals between the inner ear and the brain. […] Your doctor may suggest a hearing screening to identify any hearing loss. […] A diagnosis of definite Mnires disease is based on your medical history and on the presence of two or more spontaneous episodes of vertigo lasting 20 minutes to 12 hours.

• #38 Vestibular Balance Disorders Program | Stanford Health Care

  https://stanfordhealthcare.org/medical-clinics/vestibular-balance-disorders-program.html

  We may recommend a specialized exercise program to help you improve your balance and cope with dizziness. […] If you have BPPV, small calcium carbonate crystals (otoconia) in your inner ear loosen when your head moves, causing dizziness. […] Our doctors may recommend changes to your lifestyle to reduce dizziness and control symptoms, including: […] Your doctor may prescribe medications to help with dizziness, feeling like you’re spinning or moving (vertigo), or nausea. […] At Stanford Health Care, our surgeons offer the latest techniques and least invasive options to help treat balance disorders. […] We may recommend surgery if you have Meniere’s disease, acoustic neuroma, or SCDS. […] We use stereotactic radiosurgery to treat noncancerous tumors in the brain (acoustic neuroma) that cause balance disorders. […] As a leading academic and research institution, we are always striving to find new techniques and apply the latest and best technology to your treatment. […] We are committed to bringing you clinical trials that test new and better ways to diagnose, treat, and manage balance disorders.

• #39 Balance problems: what causes poor balance? | Spire Healthcare

  https://www.spirehealthcare.com/health-hub/specialties/ear-nose-and-throat/balance-problems-what-causes-poor-balance/

  Treatment involves repositioning manoeuvres (Epley manoeuvres), which are highly successful in removing the dislodged crystals so they no longer trigger symptoms. […] This refers to an infection of the vestibular nerve, which runs from your inner ear to your brain. It causes severe dizziness and vertigo, which can last for hours or days, to the extent that you cant get out of bed. […] Vestibular neuritis and labyrinthitis usually get better on their own. […] Also known as a vestibular migraine, this refers to a general feeling of imbalance and disconnectedness, which can occur alongside a headache, as well as other migraine symptoms, such as nausea and sensitivity to sound, light and movement. […] Around one in every 1,000 people in the UK has Meniere’s disease, which is thought to affect the pressure levels in the inner ear. This causes severe vertigo, nausea and vomiting these attacks can last 12-24 hours.

• #40 Diagnosis and Management of Balance/Vestibular Disorder: A Team-Based Approach

  https://www.asha.org/articles/diagnosis-and-management-of-balance-vestibular-disorder/?srsltid=AfmBOop11GIcJnP8ePl10FxuzXPLSbkwv-L2xSmc1uTNqehj7oFUPscC

  Balance and vestibular disorders are major health concerns. According to the National Institute on Deafness and Other Communication Disorders (NIDCD, 2015), it was estimated that 40% of the population, at some point in their lifetime, will experience some form of balance or vestibular disorder. […] Balance/vestibular disorders can be complex and difficult to diagnose, as they can have multiple causes that often cannot be isolated to a single source. […] The most effective way to manage dizziness in patients is with a multidisciplinary team or an IPE/IPP-based approach. […] Evidence supports the fact that, when applied appropriately, the IPE/IPP model will improve patient outcomes.

• #41 Balance System Disorders

  https://www.asha.org/practice-portal/clinical-topics/balance-system-disorders/?srsltid=AfmBOoqNOq4h_vlL3ZH27trVR01boZhRXy5gECajqyiMO_bI3VW3q7Mn

  The scope of this page includes balance system disorders across the life span. […] A functioning balance system allows a person to move through the environment without falling and to be aware of ones physical position in relation to gravity. Disturbances to one or more of these systems may result in a balance system disorder, which can have a negative impact on balance and/or cause symptoms such as dizziness. […] Assessment and management of balance system disorders and their symptoms is an interprofessional endeavor, at times involving audiology, behavioral health, cardiology, neurology, neuro-ophthalmology, neurotology, occupational therapy, otolaryngology, otology, physical therapy, and/or a primary care provider. […] Approximately 33.4 million adults in the United States report a dizziness or balance problem during the past 12 months.

• #42 Balance System Disorders

  https://www.asha.org/practice-portal/clinical-topics/balance-system-disorders/?srsltid=AfmBOoqNOq4h_vlL3ZH27trVR01boZhRXy5gECajqyiMO_bI3VW3q7Mn

  Causes of balance system disorders may include, but not be limited to, acute injury to the vestibular system, aging vestibular system, alcohol and/or drug ingestion, benign paroxysmal positional vertigo (BPPV), and Mnires disease. […] Audiologists play a role in the screening, assessment, diagnosis, and management of persons with balance system disorders, often as part of an interprofessional collaborative team. […] The assessment of a patient with dizziness and/or imbalance complaints includes aspects of the central and peripheral vestibular system as well as sensory and motor balance components. […] Accurate differential diagnosis of balance system disorders relies partly on the audiologists interpretation of a test battery within the context of the individuals medical history. […] Management of balance and vestibular disorders may include medical, surgical, and/or rehabilitative approaches. […] Canalith repositioning procedures (CRPs) are maneuvers used in the management of benign paroxysmal positional vertigo (BPPV).

• #43 Balance System Disorders

  https://www.asha.org/practice-portal/clinical-topics/balance-system-disorders/?srsltid=AfmBOoqNOq4h_vlL3ZH27trVR01boZhRXy5gECajqyiMO_bI3VW3q7Mn

  Causes of balance system disorders may include, but not be limited to, acute injury to the vestibular system, aging vestibular system, alcohol and/or drug ingestion, benign paroxysmal positional vertigo (BPPV), and Mnires disease. […] Audiologists play a role in the screening, assessment, diagnosis, and management of persons with balance system disorders, often as part of an interprofessional collaborative team. […] The assessment of a patient with dizziness and/or imbalance complaints includes aspects of the central and peripheral vestibular system as well as sensory and motor balance components. […] Accurate differential diagnosis of balance system disorders relies partly on the audiologists interpretation of a test battery within the context of the individuals medical history. […] Management of balance and vestibular disorders may include medical, surgical, and/or rehabilitative approaches. […] Canalith repositioning procedures (CRPs) are maneuvers used in the management of benign paroxysmal positional vertigo (BPPV).

• #44 Balance Disorders (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/balance-disorders.html

  To look for a balance problem, the doctor will ask about symptoms and do an exam, including watching a child walk, checking their balance, and testing their motor skills. […] The doctor might want the child to see an audiologist (a hearing and balance specialist), an otolaryngologist (an ear, nose, and throat specialist, or ENT), a physical therapist, and/or a neurologist (a brain and nervous system specialist). […] Tests done to look for a problem can include: imaging tests, like an MRI or a CT scan, hearing tests to check hearing sensitivity and middle ear functioning, electronystagmogram (ENG) to assess balance using electrodes placed around the eyes while a computer monitors involuntary eye movements, videonystagmography (VNG), in which the child wears special video recording goggles to measure eye movement while they focus on various targets, vestibular evoked myogenic potential (VEMP), which uses electrodes on the head and neck to measure muscle contractions (cervical) and eye movements (ocular) in response to loud clicks, video head impulse test (vHIT), which uses special goggles to check parts of the inner ear as the head is moved in different directions, rotary chair testing, which uses goggles and a special chair to assess vestibular function for differences between the two ears, posturography, which measures the ability to balance while standing on a stable or unstable platform, balance questionnaires for kids who can describe their level of dizziness throughout the day while doing different things. […] Diagnosing and treating balance disorders early can help kids become steadier and more coordinated, do the things they like, and feel better.

• #45 Assessment of balance disorders – Differential diagnosis of symptoms | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/711

  Balance disorders are common and may significantly impact upon quality of life and independence. Impaired balance may result in falls with resulting morbidity and mortality, particularly in older people. […] The prevalence of balance problems at age 70 years is reported to be 36% in women and 29% in men. […] Symptoms of dizziness or vertigo may constitute between 1% and 15.5% of primary care consultations. […] Among the most commonly reported aetiologies in primary care are vestibular/peripheral (5.4% to 42.1%), benign paroxysmal positional vertigo (4.3% to 39.5%), cardiovascular disease (3.8% to 56.8%), psychogenic (1.8% to 21.6%), Meniere’s disease (1.4% to 2.7%), neurologic disease (1.4% to 11.4%), vestibular neuritis (0.6% to 24%), and no clear diagnosis (up to 80.2%).

• #46 Balance System Disorders

  https://www.asha.org/practice-portal/clinical-topics/balance-system-disorders/?srsltid=AfmBOoqNOq4h_vlL3ZH27trVR01boZhRXy5gECajqyiMO_bI3VW3q7Mn

  The true incidence and prevalence of balance system disorders in adults and children are unknown. […] A systematic review of the research by Murdin and Schilder identified that the rate of vestibular dysfunction increases with age, and women are more likely to experience dizziness and vertigo symptoms than men. […] Balance difficulties are a significant risk factor that contribute to falling injuries. […] Statistics for balance system disorders can vary by type of disorder and how long it lasts. […] Dizziness and balance disorders can also occur in children. […] Identifying children with balance disorders, vestibular deficits, or dizziness can pose additional challenges when compared to adults. […] The underlying causes of balance disorders and the resulting symptoms are many and varied.

• #47 Balance problems: Symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/balance-problems

  Most balance problems occur because of brain or inner ear problems, or physical issues, such as broken bones or muscle injuries. […] While many balance problems are relatively harmless, it is impossible for a person to diagnose the cause on their own. […] People who experience trouble with balance and coordinating their movements should see a doctor if symptoms persist. […] Diagnosing balance problems usually begins with looking at a persons medical history. A doctor may also perform several tests, including: […] A person can often improve their balance with home exercises and physical therapy. […] It is normal to feel dizzy when sick, tired, drunk, or under the influence of certain medications. […] However, chronic balance problems may indicate a serious medical condition. Prompt diagnosis and treatment can improve outcomes and, in some cases, may even save lives. […] See a doctor if a person experiences: […] Go to the emergency room if a person experiences dizziness after a fall or car accident, or if there are signs of a stroke, such as slurred speech or numbness on one side of the body.

• #48 Balance problems: Symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/balance-problems

  Most balance problems occur because of brain or inner ear problems, or physical issues, such as broken bones or muscle injuries. […] While many balance problems are relatively harmless, it is impossible for a person to diagnose the cause on their own. […] People who experience trouble with balance and coordinating their movements should see a doctor if symptoms persist. […] Diagnosing balance problems usually begins with looking at a persons medical history. A doctor may also perform several tests, including: […] A person can often improve their balance with home exercises and physical therapy. […] It is normal to feel dizzy when sick, tired, drunk, or under the influence of certain medications. […] However, chronic balance problems may indicate a serious medical condition. Prompt diagnosis and treatment can improve outcomes and, in some cases, may even save lives. […] See a doctor if a person experiences: […] Go to the emergency room if a person experiences dizziness after a fall or car accident, or if there are signs of a stroke, such as slurred speech or numbness on one side of the body.

• #49 Balance problems: Symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/balance-problems

  Most balance problems occur because of brain or inner ear problems, or physical issues, such as broken bones or muscle injuries. […] While many balance problems are relatively harmless, it is impossible for a person to diagnose the cause on their own. […] People who experience trouble with balance and coordinating their movements should see a doctor if symptoms persist. […] Diagnosing balance problems usually begins with looking at a persons medical history. A doctor may also perform several tests, including: […] A person can often improve their balance with home exercises and physical therapy. […] It is normal to feel dizzy when sick, tired, drunk, or under the influence of certain medications. […] However, chronic balance problems may indicate a serious medical condition. Prompt diagnosis and treatment can improve outcomes and, in some cases, may even save lives. […] See a doctor if a person experiences: […] Go to the emergency room if a person experiences dizziness after a fall or car accident, or if there are signs of a stroke, such as slurred speech or numbness on one side of the body.

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