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Balance is a complex process that is achieved and maintained through the coordinated input of three primary systems:
These systems work together to send sensory information to the brain, which processes the input and generates motor responses to help maintain posture, stabilize vision during movement, and ensure overall balance.
When one or more of these systems is not functioning properly, it can result in symptoms such as dizziness, vertigo, imbalance, unsteadiness, or even falls. Vestibular testing allows us to identify whether the issue lies within the inner ear (peripheral vestibular system) or elsewhere, helping guide accurate diagnosis and treatment planning.
Videonystagmography (VNG)
VNG is a cornerstone of vestibular assessment. This non-invasive test tracks involuntary eye movements (nystagmus) using infrared goggles. It evaluates how well your inner ear and brain coordinate to maintain balance and stable vision, particularly under different conditions like positional changes or visual stimuli.
Video Head Impulse Test (vHIT)
vHIT evaluates the vestibulo-ocular reflex (VOR) by measuring eye movement response to quick, unpredictable head movements. This test provides critical information about the function of the semicircular canals and can detect subtle deficits that may not be evident during other exams.
Positional Testing including Dix-Hallpike Testing
These tests assess whether changes in head or body position provoke symptoms or abnormal eye movements. Positional nystagmus can help differentiate between central and peripheral causes of dizziness. A gold-standard test for diagnosing BPPV, the Dix-Hallpike involves specific head and body movements to elicit vertigo and nystagmus. A positive result confirms BPPV, a condition that can often be treated with repositioning techniques.
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