VESTIBULAR EVALUATION for patients experiencing vertigo or dizziness
Vestibular disorders are the most common cause of dizziness and vertigo… and are usually treatable. The vestibular organ is a part of the inner ear (cochlea). The vestibular organ is a motion sensor that can detect angular motion and linear motion. When angular motion is detected in the normal vestibular system, there is an equal and opposite eye reflex to stabilize the visual field when the head or body is moving. When this reflex is impaired, the person is unsteady and may experience vertigo: the sensation of spinning when the body is not spinning. This sensation can be triggered in a person with a normal vestibular system by spinning around and then abruptly stopping because it takes a few seconds for the fluid in the vestibular organ to stop moving. When this sensation occurs spontaneously or with positional changes, this is called vertigo. Vertigo does not occur spontaneously in a normal vestibular system. 

A vestibular evaluation checks to make sure that the left and right vestibular systems are working properly. We also check voluntary eye movements (pursuit, saccades, optokinetic, and gaze stabilization) to make sure those central nervous system functions are working properly…using the most advanced equipment available. The good news is that mostperipheral  vestibular conditions are treatable and when they are we will recommend the appropriate treatment…or provide immediate treatment (depending on the diagnosis).

The most accurate Vestibular Evaluation uses 4-channel infra-red video recordings of reflexive and voluntary eye movement as pictured here with our equipment . 
Festibular Evaluation
This is the only stock photo of office equipment that we used on this website. This photo is from MicroMedical. This is the equipment that we use including the most recent Video Head Impulse Tests.
Tests of Ocular Motility: Smooth Pursuit.  Saccades. Reflexive Optokinetic tracking. Gaze stability. 

Positional Tests: tests to check if any of several positions can trigger vertigo.

Rotational Tests: tests to check to see if gentle rotations trigger normal vestibular-ocular responses.

Video Head Impulse Tests: This is the most recent test to be added to the test protocol. The vHIT assesses the vestibular-ocular reflex’s ability to maintain stable vision with a quick 10° head movements. This test is capable of assessing all six semi-circular canals using a mid-frequency test stimulus that is indicative of every day vestibular function. This protocol is also used to assess cerebellar/vestibular interaction (VVOR and VORS).

Caloric Testing: Caloric testing applies a gentle warm or cool stimulus to the ear canals using water or air. This test tests the right and left vestibular system (lateral semi-circular canals) to determine if there is reduced function on either side. The caloric stimulus is a very low frequency stimulus (not by itself indicative of everyday balance function), but it is still considered to be an important procedure for testing each vestibular system separately.

Tests and Treatment for Benign Paroxysmal Positional Vertigo (BPPV): BPPV is a very common form of vertigo and is the most treatable. We have been treating this condition for 25 years. Treatment that utilizes binocular recording of vestibular-ocular reflexes increases the effectiveness of these treatments and reduces unwanted complications. 

Please contact our southtown’s office, The Audiology Center (716-712-2000), to schedule vestibular evaluation or treatment.

A complete VNG (formerly called ENG) takes approximately 60-90 minutes to complete. Certain medications may affect the results. Please do NOT take the following for at least 12 hours prior to the test:
  • Alcoholic beverages 
  • Pain medications that cause drowsiness 
  • Sleeping pills
  • Sedatives 
  • Anti-dizzy medications 
  • Anti-nausea medications 
  • Over-the-counter cold or allergy medications that may cause drowsiness 
  • Caffeinated beverages (coffee, tea, cola, chocolate) 
  • Cigarettes or other tobacco-based products 
Do NOT stop medication for endocrine disorders (thyroid, hormone), blood sugar (diabetes), blood pressure, heart conditions or seizure disorders. You can take Tylenol (acetaminophen) or Advil (ibuprofen).  

Dress comfortably. You will be on an exam table for part of the evaluation.  

NO makeup can be worn. Please be especially sure all mascara/eye makeup is fully removed.  

Although it is usually not necessary, please have someone you can call to drive you home.  

Please call if you have any questions. (716-712-2000)

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