Stony Brook Medicine provides a full range of services to help individuals with balance and vestibular disorders. The Audiologists in the Speech, Language and Hearing Department perform diagnostic evaluations on people who suffer from balance problems.
A balance disturbance may cause vertigo (sensation of the person or surroundings spinning), lightheadedness, falling or a feeling of falling, nausea, vomiting, faintness and ringing/fullness in one or both ears. Approximately 12.5 million Americans, 65years of age or older have balance symptoms that significantly impact their daily lives. However, balance disturbances are not symptoms solely of the elderly. Children, young adults and middle age adults also suffer from balance problems.
What should an individual do if they have symptoms of a balance disturbance?
Balance disturbances can be caused by medical conditions, medications, ear or nervous system problems. The frequency can range from one episode to a feeling of constant imbalance. The first step is to make an appointment with your primary care physician to evaluate any medical conditions or medications that may be causing your symptoms. He/she may refer you to the Neuro-otologist at Stony Brook. A Neuro-otologist is an Ear, Nose and Throat doctor that has specialized training in disorders that affect the ear and nervous system. Your primary doctor or the Neuro-otologist may order further testing in the Speech, Language and Hearing Department.
What tests may be ordered?
Hearing test: Many balance disorders can be diagnosed with a complete vestibular history/examination and a hearing test.
If further testing is needed one or all of the tests below can assist your physician in diagnosing your problem.
Videonystagmography / Electronystagmography (VNG/ENG): VNG uses high resolution binocular cameras with infrared illumination to record the eye movements associated with balance disorders. Click here for the link to further explanations and instructions.
Fistula Test: Air pressure is applied to each ear and eye movements are recorded using the VNG equipment. Your physician may order this to diagnose a specific problem called perilymph fistula (an opening in the membrane between the inner and middle ear). The test only takes 10 minutes but is usually performed with other balance tests.
Electrocochleography (Ecochg): Performed to determine if there is excessive fluid or pressure in the inner ear, that often points to Meniere’s Disease. The person lies comfortably in a recliner while hearing sounds. The person does not respond to the sounds. Skin surface electrodes pick up a response from the balance system. The test takes approximately 40 minutes. Click here for the link and further instructions.
Vestibular Evoked Myogenic Potential (VEMP) This test measures the response of the saccule, which is part of the balance system in the inner ear. Skin surface electrodes are placed on the neck, sternum and head. The person is seated and turns the head to contract the neck muscle. Tones are presented to the ear for brief periods. The test takes approximately 40 minutes. Click here for the link and further instructions.
Auditory Brainstem Response (ABR) This test is performed to assess the function of the hearing nerve. It is not a test for dizziness but may be recommended for some people who suffer from dizziness or imbalance. Surface skin electrodes are placed behind the ears and forehead. The person lies comfortably in a recliner while hearing sounds. The person does not respond to the sounds. The test takes approximately 40 minutes. Click here for the link and further instructions.
After your tests have been completed, results will be analyzed and a report will be sent to the referring physician.