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Vestibular Evaluations (Balance Assessment)

If you suffer from dizziness or vertigo, a vestibular assessment may be appropriate for you. Part of the balance system, or vestibular system, is located in the inner ear. A comprehensive vestibular assessment is required to assess the peripheral and central mechanisms responsible for maintaining proper balance and postural control. St. Elizabeth’s Medical Center offers comprehensive assessment of the vestibular system using state-of-the-art equipment performed by highly trained staff. 

Symptoms of a balance disorder include:
•    Dizziness
•    Vertigo
•    Lightheadedness
•    Off-balance
•    Drifting
•    Floating sensation

Services
Rotary Chair: Oculomotor, optokinetic and vestibular assessments are used to detect and quantify the causes of balance instability and dizziness. Rotary chair assessment is used to differentiate central from peripheral pathologies, as well as site of lesion analysis involving the utricle, which is part of the vestibular system.

Videonystagmography (VNG): VNG testing is commonly administered to people with dizziness, vertigo, and/or balance disorders. VNG consists of a battery of subtests utilizing visual, positional and temperature stimuli that differentiates vestibular from central neurological dysfunction. Goggles are worn during the evaluation to track eye movement in response to stimuli employed in the various subtests. 

Vestibular Evoked Myogenic Potential (VEMP): VEMP testing is used to evaluate the functioning of the saccule and inferior vestibular nerve, which are parts of the vestibular system. Adhesive electrodes are attached to neck muscles, earphones deliver a sound to the ear and the response of the muscle is recorded.

Electrocochleographgy (ECochG): ECochG evaluates activation of the spiral ganglion within the cochlea and specifically examines the presence of hydrops associated with Ménière's disease. The response is measured either deep in the ear canal or on the tympanic membrane. 

Caloric Evoked Responses: Irrigating the external auditory meatus with hot and cold stimuli evokes a predictable nystagmus response. Abnormal responses provide information regarding the site of lesion in the peripheral vestibular system.