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According to the National Institutes of Health (NIH), vertigo/dizziness is the third most frequent health complaint of all patients, after headache and lower back pain. It is the number one complaint of all patients over age 70. We have added new state-of-the-art equipment to better serve our patients with balance and dizziness issues.
The ICS Chartr Videonystagmography (VNG) Vestibular Diagnostic System allows our audiologists to assess problems of balance through a battery of tests. During testing, video goggles with infrared cameras record eye movement, which can reveal abnormalities in the balance system. These involuntary eye movements, called nystagmus, are characterized by the eye jerking back and forth.
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Dr. Susan Parr places the video goggles
on a patient.
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Dizziness and balance problems are typically tested over several sessions. During the initial test session, a diagnostic audiological evaluation is performed to assess the functioning of your ears and your hearing. During the following session, a thorough case history is taken to better understand your problems and determine the appropriate testing. A portion of the audiological testing may be repeated and then the VNG battery can be completed. It consists of eight main tests: gaze, saccades, horizontal tracking, optokinetic nystagmus, positional, Dix-Hallpike maneuvers, calorics and headshake.
Previously, eye movement was recorded using electrodes placed on the face around the eyes, known as electronystagmography (ENG). Advances in technology have given the VNG several key advantages over the ENG. The use of the infrared goggles during the VNG testing means that there will be no application of electrodes on the face. The resulting traces of eye movements, unlike those created by electrodes, are not affected by other physiological and environmental noise. This allows for “cleaner” tracings, which are more easily interpreted.
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Eye movement is displayed, along with tracings,
on the computer monitor.
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During testing, the camera display is shown on the computer monitor, so that the audiologist can easily visualize eye movements, even while your head is turned away or in darkness. The camera display of eye movements can be recorded in standard video format. This allows the audiologist to retrieve the recording to review at a later time. These video recordings, along with data tracings, normative data, and statistical analysis, can be sent to your physician for a comprehensive diagnostic picture of your balance problems.
We may be able to alleviate
or cure some types of vertigo. The
audiologist may also work with the physician, otolaryngologist, or other
professionals to develop and direct individual vestibular rehabilitation
programs. There are several types of vestibular disorders that may be
helped by vestibular rehabilitation.
Benign
paroxysmal positional vertigo (BPPV) or canalithiasis is a specific
type of vertigo that occurs most often in adults 50 and older.
It
accounts for over 160,000 new cases of dizziness each year in the United States.
BPPV’s exact cause may be unknown.
An upper respiratory infection or a blow to your head that jostles
internal ear structures can lead to the dizziness. Many cases are probably a
natural result of aging. Your inner
ear consists of three semicircular canals that contribute to your sense of
balance. Over time, particles, very
small crystals of calcium carbonate in your inner ear can break off and
accumulate behind a membrane in the posterior canal.
Moving your head in certain directions may cause these particles to tug on
hairlike sensors, triggering a specific type of dizziness.
The symptoms of BPPV include dizziness or vertigo, light-headedness,
imbalance, and nausea. Activities that bring on symptoms will vary in each person,
but symptoms are almost always precipitated by a position change of the head or
body. During the past few years, a
treatment for BPPV has become increasingly successful.
The Canalith Repositioning Procedure involves five simple maneuvers that
move stray particles from the posterior semicircular canal into the utricle. We offer
this treatment in our offices. Many times only one treatment is needed to cure
BPPV with a 90% success rate.
Meniere’s
Disease does not respond to vestibular rehabilitation.
This is a symptom triad of vertigo, tinnitus, and fluctuating low
frequency hearing loss. Fullness in one ear can also be present.
The tinnitus is loud during an attack of vertigo.
Hearing and understanding is diminished on the side with the tinnitus.
In Meniere’s Disease the diseased ear is stimulated by the accumulation
of endolymph fluid so it is also called endolymphatic hydrops. Your ENT
physician can offer you treatment.
GN Otometrics has provided information in this section. You can visit their website.
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Links
to other informational websites:
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