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DeutschDiagnosis and Treatment of Balance Disorders
Vertigo is not a disease in itself. Once the underlying cause of vertigo is diagnosed and treated, an individual can regain balance control and return to a healthy life.
The balance system is a complex structure. It is comprised of the musculoskeletal system, vision, and the inner ear as its fundamental components. A loss of function or weakness in any part of this system can cause an individual to experience imbalance or dizziness. In balance disorders, factors such as the frequency, duration, severity of the symptoms, and any accompanying signs must always be taken into account.
The inner ear on its own is a complex structure. Part of it functions as the sensory organ for hearing, while another part plays a role in the balance mechanism. In fact, these two systems are interconnected.
In some balance disorders, hearing is affected, while in others it is not. Therefore, individuals with balance disorders must always undergo auditory evaluations to ensure an accurate diagnosis.
There are various methods to diagnose the disorder that causes dizziness. Each diagnostic method used in balance disorders sheds light on a different aspect. Moreover, the findings in diseases that cause balance disorders are very similar. A detailed diagnostic approach is essential for proper treatment.
Doctor Audiologist Emel Uğur
Dr. Audiologist Emel Uğur was born in 1982 in Çanakkale. During her 15-year tenure at Istanbul Training and Research Hospital, she primarily worked on Pediatric Audiology (Hearing Loss in Infants and Children), Otological Diseases (Ear Diseases and Hearing Health), and Vestibular System Disorders (Vertigo and Imbalance). In 2015, she joined the Acıbadem Healthcare Group.
About Me
DIAGNOSTIC METHODS FOR BALANCE DISORDERS AND DIZZINESS
- VIDEO NYSTAGMOGRAPHY (VNG): VNG evaluations are based on recording and analyzing eye movements. It is a battery of tests that combines numerous assessments to check the reflex connections between the inner ear and vision. Various tests, such as gaze tests, oculomotor tests, and positional tests, are used to evaluate the patient’s involuntary eye movements (nystagmus).
- Caloric Test: This is a highly valuable diagnostic method based on stimulating the ear with warm and cold air. It can also be performed using water instead of air.
- VEMP: This electrophysiological method is used to determine the cause of the patient’s balance disorder. An acoustic stimulus is applied to the ear while an EMG recording is taken from the muscles involved in the balance mechanism.
- V-HIT: This is a very fast and highly valuable test that enables the evaluation of the function of each semicircular canal in the inner ear individually. vHIT provides an objective assessment of the vestibulo-ocular reflex (VOR) function in response to head movements.
- Computerized Dynamic Posturography: This is a test battery system that objectively analyzes various balance conditions and the individual’s reflex responses. Especially in individuals with chronic balance disorders and in elderly patients, there are often disruptions in the integration of the systems that comprise the balance mechanism rather than a specific dysfunction. Dynamic posturographic measurements provide important information regarding which mechanism the patient is not effectively utilizing and which function needs to be compensated for or improved. For this reason, the dynamic posturography system is also used in balance rehabilitation.
The diagnostic methods used for dizziness and balance disorders assess the reflex arcs involved in the balance system—in other words, they evaluate aspects of the central nervous system. Therefore, the use of certain medications prior to performing balance tests may suppress the findings. You may need to discontinue these medications before beginning balance tests. Be sure to consult with your audiologist regarding this matter. Medications such as those for hypertension, diabetes, heart conditions, and antidepressants should not be discontinued without your doctor’s supervision.
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TREATMENT OF BALANCE DISORDERS
REPOSITIONING MANEUVERS
BPPV is the most common complaint of dizziness. Repositioning maneuvers are the most effective method. Supporting these maneuvers with home exercises accelerates the recovery process. Sometimes, following these maneuvers, supportive and recovery-enhancing home exercises may be recommended.
HOME EXERCISES – VESTIBULAR REHABILITATION
The primary goal of vestibular rehabilitation exercises is to accelerate vestibular compensation, correct and improve the patient’s current faulty balance strategies, develop alternative balance strategies, and enhance the individual’s quality of life.
However, as with all other rehabilitation services, programs created for vestibular rehabilitation must be tailored to the individual. After a detailed audiovestibular system examination, your audiologist will determine a program specific to you.
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MEDICAL TREATMENTS
If your doctor deems it appropriate, you may need to use medication for dizziness. Your doctor will determine which medication to use and for how long. Because taking prescribed medications for an extended period can be dangerous for individuals with dizziness, you must use them only as directed by your doctor.
SURGICAL TREATMENTS
For some conditions that cannot be resolved with medical or rehabilitative treatment approaches (such as Meniere’s, Vestibular Schwannoma, etc.), surgical treatment options are available. However, a detailed examination is required before resorting to these options. For example, while surgical intervention is not the primary approach for Meniere’s disease, it may be the primary approach for acoustic neuroma.
Individuals with balance disorders must also undergo auditory evaluations.
