Do you sometimes feel dizzy? As if the world is spinning. Or do you feel like you're going to lose your balance and fall when you walk or stand? Today we're going to talk about a very important series of tests that are done to find the exact cause of these symptoms. This is called vestibular testing.
Simply put, what is vestibular testing?
Think of our body as a car. The main part of this car that helps it to stay balanced and not sway is the balance system in our inner ear. In medicine, we call this the vestibular system . So, if you have symptoms like dizziness and problems with your balance, your doctor may order this series of tests to see if your vestibular system is working properly.
This vestibular system has several main parts.
- Semicircular canals: These are like sensors that detect head movements.
- Otolith organs: These are sensors that detect gravity.
- Vestibular nerve: Information from this system is carried to the brain through this nerve.
These tests assess how well these parts work together to coordinate your body's movements and maintain balance.
Why is the doctor asking you to do this test?
These tests help determine whether the dizziness you are experiencing is actually due to an inner ear problem or a related neurological problem in the brain.
This allows the doctor to diagnose certain medical conditions. For example:
- Benign Paroxysmal Positional Vertigo (BPPV)
- Labyrinthitis
- Ménière's disease
- Vestibular Neuritis
These tests can also help confirm that your symptoms are not caused by an inner ear problem. Sometimes, symptoms like dizziness can be caused by vision problems, medications, other medical conditions, or accidents. So this test is very important to find out the exact cause.
How do these tests work?
These tests are performed by a specialist in hearing and balance disorders. We call him an Audiologist. He will ask you questions while showing you how to do various simple activities. Don't worry, he will teach you everything step by step.
Three main systems must work together to maintain balance in our body.
1. Vision: Things we see with our eyes.
2. Proprioception: The way our skin, especially our feet, feel the ground.
3. Vestibular system: The balance system in the inner ear.
These tests look at how these three systems work together.
One of the most important reflexes in our vestibular system is the vestibulo-ocular reflex (VOR) . Simply put, it helps you to see clearly and in one place, even when your head or body is moving. Imagine that you are sitting on a bus and reading a sign outside. Even though you are shaking your head, you can still see the letters on the sign clearly, right? This reflex called the VOR helps you to do that.
The specialist who is performing the test will watch your eye movements carefully, because your eyes can provide important information about how your vestibular system is working. Sometimes they will also check for nystagmus , which is rapid, uncontrolled eye movements.
How should I prepare before the test?
It is very important to follow the instructions given by your doctor or audiologist exactly. The instructions you will usually receive are as follows:
- Bring someone home with you: You may feel a little dizzy or lightheaded after the test. For your safety, it's best to have someone drive you home without driving.
- Follow your medication instructions: Some medications can affect the test results. So, ask your doctor exactly what medications you should stop taking and what you should continue taking in the days before the test.
- Be careful about what you eat and drink: Sometimes you may be asked to eat only a light meal before the test, or to fast for a few hours. You should definitely stop drinking alcohol.
- Do not wear eye make-up: This is very important. Things like eyeliner and mascara can interfere with the test, as your eye movements need to be clearly observed.
What happens during the test? Let's learn about each type of test.
There are several types of vestibular tests. Your audiologist will decide which tests you need based on your symptoms. You may not need to do all of them. Let's look at some of the main types of tests.
| Test Name | What do you see in this? | What do you have to do? |
|---|---|---|
| Electronystagmography (ENG) and Videonystagmography (VNG) | It checks the health of the nerves in the brain that control eye movement, hearing, and balance. | You are asked to do things like look at a target and watch it move, and move your head and body into different positions. Sometimes you put a little bit of ice or hot water/hot water in your ear and watch how your eyes react. In VNG, you have to wear glasses with a camera. |
| Rotary Chair Test | It measures how well your eyes and vestibular system work together to keep your vision stable as you move. | You have to wear special glasses and sit in a motorized chair. You have to keep your eyes open as the chair slowly rotates left and right. The glasses record your eye movements. |
| mCTSIB | They look at how your vision, touch (what you feel in your feet), and inner ear affect your dizziness. | You will be asked to stand without moving for 30 seconds, first on a hard surface, then on a soft surface such as foam, without shoes. You may be asked to do this with your eyes closed. |
| Video Head Impulse Test (VHIT) | The three semicircular canals in the inner ear are tested to see how well they detect head movements. | You wear glasses with a camera and look at a target. The specialist will slowly move your head left/right or up/down. They will measure whether you can keep your eyes on the target as you move your head. |
| Vestibular Evoked Myogenic Potentials (VEMP) | It examines how the two otolith organs (saccule and utricle) in the inner ear function. | Several electrodes are attached to your neck. You wear headphones and turn your head left and right while looking at a target. During this time, you hear different sounds through the headphones. The electrodes measure how your neck muscles respond to those sounds. |
What happens after the test?
How long does the test take?
This usually takes about two hours, but depending on your symptoms and results, the test may take less time.
Are there any risks with these tests?
Vestibular tests are very safe tests. There is nothing to be afraid of. However, you may feel a little dizzy during the test and for a while afterwards. That is why we said earlier that it is better to have someone accompany you home.
What kind of results will I get?
You can get one of two main types of results:
- Normal results: This means that your symptoms are not caused by a defect in the vestibular system.
- Abnormal results: This means that a problem with the vestibular system or related nervous system is contributing to your symptoms.
When will I get the results?
In most cases, the audiologist will explain the results to you as soon as the test is complete. Sometimes, if more time is needed to study the results thoroughly, you will be informed about this later. These results will also be sent to the doctor who referred you for the test.
What to do next?
The next step will be determined based on your results.
- Perhaps your doctor can refer you to another specialist.
- You may also be asked to do further tests, such as an MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scan , to see if there is any damage to the bones or soft tissues of the inner ear.
Hearing about all these tests can be a bit overwhelming. But they are actually very simple and straightforward tests. There is no need to be afraid because the audiologist will explain everything to you. By having this test, you will be one step closer to finding the real cause of your symptoms and starting the necessary treatment.
Take-Home Message
- If you frequently experience dizziness, vertigo, or balance problems, Vestibular Testing is a series of tests that are performed to determine the cause.
- This mainly tests the functioning of the balance system in your inner ear.
- These are very safe, simple tests and there is no reason to be afraid.
- Follow the doctor's instructions carefully before the test (medication, food, no makeup, and having someone accompany you home).
- Based on the results of the test, your doctor will be able to accurately diagnose your condition and develop the most appropriate treatment plan for you.
- Dizziness and loss of balance are not symptoms to ignore. Be sure to talk to your doctor about this.
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