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Vertigo Testing

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Vestibular assessment VGN-Videonystagmography VHI

The VHIT is an instrumented bedside technique used to diagnose reduction in vestibular function in one ear vs. the other. An examiner abruptly accelerates and then decelerates the head, moving the head rapidly at high speed and then stopping it.

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What is vertigo test?

Vertigo causes and treatment dizziness. The sense of dizziness or spinning. It is a false sensation of movement. The person feels like he is spinning or the world around him is spinning. It is caused due to the problem with the inner ear, brain or sensory nerve path. Vertigo can occur at any age but usually it happens in people aged above 65 years.

Vertigo causes can be barely noticeable or can be very severe which makes your day to day activities unmanageable. Vertigo attacks can develop suddenly and last for second or it may last for much longer.

1. Vestibular Neuronitis:

  • This is a condition which occurs due to viral infections and causes inflammation in the vestibular nerve, resulting in vestibular neuronitis.

2. Labyrinthitis:

  • It is an inflammation in the vestibulocochlear nerve, which is responsible for encoding body’s position, motion as well as sound and the inner ear labyrinths. Inflammation is usually caused due to viral infections

3. Meniere’s Disease:

  • It is the formation of fluid in the inner ear causing leading to tinnitus (Ringing in the Ear) and hearing loss triggering vertigo attacks.

4. Cholesteatoma:

  • It is the abnormal growth of skin in the middle ear as a result of persistent infections. The increased growth damages the ear, leading to hearing loss and dizziness.

5. BPPV:

  • Benign Paroxysmal Positional Vertigo is when the calcium carbonate crystals are formed in the inner ear canal. This causes balance loss in the person. BBPV can occur without any reason and is most common found in older people.

1. Some of the conditions associated with vertigo are:

  • Head or neck injury
  • Migraine
  • Ear surgery
  • Certain medications
  • Otosclerosis
  • Brainstem disease
  • Stroke

2. Signs and symptoms, you need to consider:

  • Light headiness
  • Headache
  • Motion sickness
  • Tinnitus
  • Abnormal eye movement
  • Neck pain
  • Loss of consciousness or fainting
  • Dizziness

Available treatments for vertigo:

Vertigo causes and treatment of dizziness depends on the causes and severity of the condition. Some of the common treatments include:

1. Medications:

  • Medications are prescribed based on the cause, such as water pills for meniere’s disease, anti-anxiety medications, preventive medications for migraine and antihistamines and anticholeretics.

2. Balance therapy:

  • It is commonly recommended to people with condition vestibular neuritis. It is physical therapy which makes your motion system less sensitive to motion. It is also called as vestibular rehabilitation.

3. Head position maneuvers:

  • It is a technique called epley maneuver or canalith re-positioning, It helps to resolve benign paroxysmal positional vertigo quicker than simply waiting your dizziness to go away. It is done by an audiologist or a physical therapist. Before starting this procedure of Vertigo causes and treatment of dizziness always tell your doctor if you have any back or neck pain, blood vessel problems or detached retina.

4. Ear injections:

  • Antibiotic gentamicin injections will be injected in the inner ear to disable the balance function and helps the unaffected ear to take over the function.

5. Inner ear sense organ removal:

  • This technique is used if the condition is serious. It is a rarely used procedure called labyrinthectomy. It disables the vestibular labyrinth in the infected ear, and helps the other ear take over the balance function.

Vestibular Evoked Myogenic Potential (VEMP)

  • Vestibular evoked myogenic potential (VEMP) is an emerging diagnostic tool for identifying vestibular lesions. The VEMP test is noninvasive and causes little or no discomfort to the patient. The VEMP test is administered like the traditional auditory brain stem response [ABR] test using surface electrodes placed on sternocleidomastoid muscles to detect sound evoked potentials due to inhibitory muscle activity in response to suprathreshold tonal sounds in each ear. VEMP testing targets the vestibule and neural connections to the sternocleidomastoid muscles of the neck. VEMP is a relatively new vestibular function test performed by stimulating one ear with repetitive pulse or click sound stimulation and then measuring surface EMG responses over selected muscles averaging the reaction of the muscle electrical activity associated with each sound click or pulse.

    There are 2 types of VEMP testing :

    cVEMP and oVEMP. A sound stimulus applied to one ear evokes a response within the ipsilateral sternocleidomastoid muscles that can be recorded with surface electrodes and averaged (cVEMP). Similarly, a sound stimulus to the ear also evokes a response that is largest when recorded from the contralateral inferior oblique muscle recorded by a surface electrode and averaged (oVEMP)

    Methodology :

    VEMPs are recorded using an evoked response computer, a sound generator, and surface electrodes to pick up neck muscle activation or other muscles.