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Balance Disorders: Assessment and Treatment

Barbara-Madden.JPGBy: Barbara Madden, Au.D., Director/Doctor of Audiology

When people say they're dizzy, they are often describing a variety of perceptions and feelings. Most commonly, vertigo (spells of spinning with nausea) and lightheadedness (or near fainting) are reported. There may
also be sensations of imbalance or loss of consciousness. Not only are these
feelings frightening, they are often accompanied by other symptoms, such as vomiting, headaches, falling to the side or forward. People often report difficulty focusing and decreased concentration

Impaired balance is common and often a debilitating problem, especially
as we age. Statistics indicate that dizziness is one of the most common reasons for doctor visits, especially for those over the age of 75. There is
good reason to be concerned about balance problems; dizziness can lead
to falls. Falls are the leading cause of injury for people over the age of 65
with nearly 50% of people in this age group experiencing falls.

Balance is a complicated function and one that is controlled, in part, by the vestibular system, which is
the sensory organ for balance in the inner ear. The vestibular system has several very important roles, most importantly to sense and perceive the body’s position and motion and to maintain balance as we move. Loss of balance or dizziness occurs when the vestibular system malfunctions. Clinical testing by an audiologist, in conjunction with a doctor’s examination, can determine if the symptoms are caused by an inner ear condition, a disruption of the central nervous system or some other cause.

Evaluation by an audiologist will include a thorough case history. Testing may include a complete evaluation of hearing, middle ear function and a specialized procedure, called the VNG (VideoNystagmoGraphy). The VNG is a test of the vestibular system and includes observation of involuntary, repetitive eye movements, called nystagmus, and controlled stimulation of the semicircular
canals in the inner ear. The VNG is performed with infrared goggles to monitor eye movements
during oculo-motor and positional subtests; the eye movements are recorded, measured and analyzed
during the procedure.

In addition to audiologic testing, your physician will most likely suggest radiographic studies, such as CT
scan or MRI, to identify structural problems within the balance organs or with the nerves connecting them
to the brain. Lab studies, including blood work and urinalysis, may rule out or confirm other medical problems contributing to a balance disorder.

Once a final diagnosis has been made, in most cases, help is available. Through vestibular rehabilitation
and balance retraining, symptoms of imbalance and vertigo can be improved. Specialists, such as
physical therapists, can develop an individualized treatment plan for strengthening the appropriate
muscles, improving flexibility, retraining the neurological/vestibular systems and introducing simple balancing activities to improve stability.

For more information or to schedule an evaluation or treatment, contact your physician for a referral to the audiologists and physical therapists at Riddle Hospital's Audiology Department.
 
Posted by Main Line Health on 3/18/2013 1:10:03 PM
Read more articles about: Riddle_Hospital, Audiology

Balance Disorders: Assessment and Treatment

Barbara-Madden.JPGBy: Barbara Madden, Au.D., Director/Doctor of Audiology

When people say they're dizzy, they are often describing a variety of perceptions and feelings. Most commonly, vertigo (spells of spinning with nausea) and lightheadedness (or near fainting) are reported. There may
also be sensations of imbalance or loss of consciousness. Not only are these
feelings frightening, they are often accompanied by other symptoms, such as vomiting, headaches, falling to the side or forward. People often report difficulty focusing and decreased concentration

Impaired balance is common and often a debilitating problem, especially
as we age. Statistics indicate that dizziness is one of the most common reasons for doctor visits, especially for those over the age of 75. There is
good reason to be concerned about balance problems; dizziness can lead
to falls. Falls are the leading cause of injury for people over the age of 65
with nearly 50% of people in this age group experiencing falls.

Balance is a complicated function and one that is controlled, in part, by the vestibular system, which is
the sensory organ for balance in the inner ear. The vestibular system has several very important roles, most importantly to sense and perceive the body’s position and motion and to maintain balance as we move. Loss of balance or dizziness occurs when the vestibular system malfunctions. Clinical testing by an audiologist, in conjunction with a doctor’s examination, can determine if the symptoms are caused by an inner ear condition, a disruption of the central nervous system or some other cause.

Evaluation by an audiologist will include a thorough case history. Testing may include a complete evaluation of hearing, middle ear function and a specialized procedure, called the VNG (VideoNystagmoGraphy). The VNG is a test of the vestibular system and includes observation of involuntary, repetitive eye movements, called nystagmus, and controlled stimulation of the semicircular
canals in the inner ear. The VNG is performed with infrared goggles to monitor eye movements
during oculo-motor and positional subtests; the eye movements are recorded, measured and analyzed
during the procedure.

In addition to audiologic testing, your physician will most likely suggest radiographic studies, such as CT
scan or MRI, to identify structural problems within the balance organs or with the nerves connecting them
to the brain. Lab studies, including blood work and urinalysis, may rule out or confirm other medical problems contributing to a balance disorder.

Once a final diagnosis has been made, in most cases, help is available. Through vestibular rehabilitation
and balance retraining, symptoms of imbalance and vertigo can be improved. Specialists, such as
physical therapists, can develop an individualized treatment plan for strengthening the appropriate
muscles, improving flexibility, retraining the neurological/vestibular systems and introducing simple balancing activities to improve stability.

For more information or to schedule an evaluation or treatment, contact your physician for a referral to the audiologists and physical therapists at Riddle Hospital's Audiology Department.
 
Posted by Main Line Health on 3/18/2013 1:10:03 PM
Read more articles about: Riddle_Hospital, Audiology
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