Balance Disorder Assessments

Signs, Symptoms and Causes

According to the American Speech and Hearing Association (ASHA), “The human balance system is complex and includes input from and coordination of three sensory systems: vestibular, visual, and somatosensory,” and a “functioning balance system allows a person to move through the environment without falling and to be aware of one’s physical position in relation to gravity.”
Balance disorders occur when there is a disturbance in the vestibular, visual, or somatosensory systems and could lead to a difficulty with balance, dizziness, or vertigo. In the case of vertigo, calcium carbonate crystals, also known as otoconia, within the inner ear become dislodged and cause the inner ear to send false signals to the brain about movement – thus causing us to feel as though the world is spinning.
The National Institute on Deafness and Other Communication Disorders estimates that approximately 40% of the population in the US will experience some form of balance difficulty in a lifetime. Signs and symptoms of balance disorders include:

  • Confusion/disorientation
  • Developmental and/or reflex delays
  • Difficulty concentrating
  • Falls
  • Fatigue
  • Headache/migraine
  • Imbalance/disequilibrium/unsteadiness
  • Impaired mobility
  • Lightheadedness/feeling faint
  • Motion sickness
  • Nausea or vomiting
  • Vertigo (dizziness, a sensation of swaying or spinning)
  • Hearing loss or tinnitus

There are many different causes for balance disorders, which may be temporary or chronic. Common causes include inflammation to the inner ear, Meniere’s disease, benign paroxysmal positional vertigo (BBPV), auto immune inner ear disease, or injury to the brain or vestibular system.

Balance Disorder Assessments

If you experience some of the above symptoms, you may have a balance disorder. Here at Aspire Hearing, we provide balance testing to determine the cause of imbalance, dizziness, or vertigo. The process will begin with a case history, to understand your medical history. While reviewing your history, we will ask you to provide information on your general health (especially blood pressure), a history of dizziness or falls, any medications you are currently taking, and any medical conditions you are currently experiencing.

We will also ask about the nature of your experience with the balance disorder. In preparation, we ask that you take note of the times and environments in which you tend to experience the symptoms. We will ask about associated symptoms (hearing loss, tinnitus, etc.) and details of the experience (imbalance, spinning, lightheadedness, disorientation, etc.).

Balance disorder assessments may be conducted in our office or bedside. We will check your vestibular ocular reflexes, otherwise known as the movement of your eyes, through a series of tests. Typically, your eye movements are linked to balance processes within your inner ear.

Benign Paroxysmal Positional Vertigo (BBPV) Assessment

Benign paroxysmal positional vertigo (BPPV) is a non-life-threatening condition that comes in brief spells, triggered by certain movements of the body or head. Vertigo is a condition in which the patient may feel off balance, like they are spinning, or that the world is spinning around them.

BPPV, a mechanical problem located in the inner ear, occurs when particles known as otoconia become dislodged and travel to fluid-filled semi-circular canals that regulate balance. The presence of otoconia within these fluid-filled canals creates the sense of head motion, which causes your inner ear to send false signals to your brain to regulate balance. When there is a mismatch between what your eyes experience and what your balance system reports, you may begin to experience imbalance or dizziness.

With a BPPV assessment, we will test your eye movement. You will be asked to move from a seated position to a supine position, with your head turned 45 degrees to the left or right and held for 30 seconds. If you are experiencing BPPV, your brain will cause your eyes to move. If BBV is detected, we are able to treat the condition with a canalith repositioning procedure, designed to move the otoconia out of your ear canals.

Canalith Repositioning Procedure (CRP)

Canalith repositioning procedure (CRP), also known as the Eply maneuver, is designed to treat BPPV. During this procedure, you will sit on the edge of a bed or bench, moving into a position in which you no longer experience vertigo. At this point, we will perform a series of repositioning movements that are designed to move the otoconia out of your canals and into another part of the ear, so that they no longer cause dizziness or spinning.

It is of utmost importance that you do not perform this procedure at home on your own, as it could result in serious injury of the neck or back. If you are experiencing BPPV, visit us at Aspire Hearing for the canalith repositioning procedure. CRP has an 80% success rate of curing vertigo after one or two treatments.