What Tests Can Be Done for Balance Issues?


Vertigo illness concept. Man hands on his head felling headache dizzy sense of spinning dizziness,a problem with the inner ear, brain, or sensory nerve pathway

Imagine taking a cruise and immediately getting seasick. It would take the fun out of everything, right? And there’s always that adjustment period when you get back on dry land where you can still feel the sway of the ship beneath your feet.

Now imagine it’s like that almost all the time–boat or no boat. That’s what having certain balance issues can seem like. And just like that cruise-caused seasickness, balance issues can take the fun (and function) out of just about anything.

In some cases, these balance issues are temporary or ebb and flow–in others, symptoms might persist. Testing to determine the cause of the balance issues you have can help you find more effective, longer-lasting treatments.

What can cause balance issues?

You have fluid in your ears. That’s it–that’s how balance works! You have a tiny bit of fluid in a special part of each inner ear, and your brain uses information from that fluid to figure out your body’s orientation. Usually, this works pretty nicely!

So when you begin to experience symptoms of balance issues, you may start wondering what could cause balance issues in the first place. Usually (but not always), it has something to do with your ear, your brain, or both. Some of the most common causes include:

  • Benign paroxysmal positional vertigo (BPPV): This is a condition in which sudden movements of the head or particular positions of the head can cause feelings of vertigo and dizziness. Move your head in a certain direction (or at a certain speed) and you get to experience an episode of vertigo.
  • Meniere’s disease: Meniere’s disease is a disorder of the inner ear that is characterized by episodes of vertigo, tinnitus, and ear pressure. Usually, Meniere’s disease starts in one ear before moving to the second–eventually resulting in loss of hearing.
  • Vestibular neuritis: This is inflammation of the inner ear. Usually, it’s caused by an infection–and it results in temporary dizziness, vertigo, and balance issues. Once the infection subsides, symptoms typically go away.
  • Migraines: These severe headaches can cause a wide variety of symptoms–one of which is balance issues. Typically, as the migraine subsides, so too do the balance problems.
  • Head injuries: Dizziness and vertigo can often result from head injuries–including mild concussions to other traumatic brain injuries. The severity of the head injury can often impact the duration and intensity of the balance issues.
  • Side-effects from medication: Some medications can cause side effects that result in dizziness and vertigo. Typically, when you stop taking those medications, the symptoms will diminish. (Talk to your provider before you discontinue taking any prescription medications.)

This list is not exhaustive, of course. In order to determine what the cause of your balance issues is, your provider will need to perform specially designed testing.

Testing for inner ear issues

When you first present with balance issues, your provider may start by first looking at your inner ear. As the name implies, your inner ear isn’t exactly easy to get to. Thankfully, these diagnostics are not uncomfortable or invasive. Here are some of the tests you might expect:

  • Audiometry: You can think of audiometry as a standard hearing test. All it does is determine how well you’re able to hear simple sounds at various frequencies. Often, this can help determine if there’s an issue with your ears or your hearing health.
  • Tympanometry: Your eardrums are critical to your ears working properly. A tympanometry test is designed to see how well your eardrums are moving. A small probe (that looks like a headphone) is placed in your ear, and then small puffs of air are directed at your eardrum. The test measures the resulting movement of your eardrums–and as a result can help determine whether your ear is healthy.
  • Videonystagmography or balance testing (ENG): It might help to think of this test as working indirectly with your ears. You wear special goggles. These goggles measure the movement of your eyes, helping to diagnose where your balance issues are coming from. This can help confirm that something is very off with your balance!
  • Electrocochleography (ECOG): This test measures how much electrical energy is created by your cochlea (which is part of your inner ear). ECOG tests are essential in diagnosing Meniere’s disease.
  • Brainstem auditory evoked response audiometry (BAER, BSER): This test monitors your brainwave activity. Essentially, it looks for activity in response to hearing stimulus. If the activity isn’t what’s expected, there could be an issue with the inner ear, how your ears and brain are communicating, or with your hearing more broadly.
  • Vestibular evoked myogenic potentials (VEMP) and Auditory brainstem response (ABR): These two tests can sense electrical activity. In general, you’ll have a couple of small electrodes placed against your skin (usually on your head), and they’ll help determine how well signals are traveling from your brain to your ears and back again.

Which test is right for you will depend on your overall health and your symptoms. In general, your provider will be able to determine when you need a simple screening or when a more objective test might be required.

How Do You Treat Balance Issues?

Once you’ve established the cause of your balance issues, your provider will be better able to offer effective treatment. Sometimes, therapies will be pretty simple. For example, if an ear infection is causing your dizziness, some antibiotics may be able to help. In other cases, more intense and sustained interventions may be required.

Some of the most common treatments for balance issues include the following:

  • Medication: In some cases, over-the-counter or prescription medication can help you control and alleviate symptoms.
  • Positioning Exercises: These exercises can help with certain types of vertigo. One popular (and often effective) such example is the Epley Maneuver.
  • Lifestyle Modification: In some cases, changing your lifestyle can help minimize your symptoms. For example, eating more fruits and vegetables or quitting smoking could help control your symptoms.
  • Vestibular rehab: These are exercises that can help improve your balance and, if successful, prevent falls. Think of it as physical therapy for your balancing skills!
  • Surgery: In some cases, surgery performed by an ENT may be necessary to address certain balance issues.

Your Balance of Power

Balance issues can profoundly impact your overall quality of life and your day-to-day safety. It’s hard to drive–or even walk around your house–when you feel dizzy and unstable. Your ENT will be able to get to the bottom of your balance issues and start working towards an effective treatment.

But the first step is finding the cause of that constant seasick feeling–so you can feel like you’re back on dry land again.

Find a provider in your area to schedule an appointment by searching providers near you.

Want more information?

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