Test to be done if you are dealing with frequent dizziness
The balance test tests the balance system and the way you get data from different sensory systems through the perception of space.
Sensory systems include the sense of balance, hearing, vision, deep and surface sensibility, and gravitoreceptors located in large blood vessels and the central nervous system.
Balance disorder is most often manifested by dizziness.
Problems with dizziness have been experienced by every person. Dizziness can occur as a result of standing up suddenly, turning the head, a rapid drop in pressure, or in the presence of foreign substances such as alcohol.
However, frequent dizziness can indicate more serious health problems related to the function of the inner ear and cerebellum, which form the center for balance.
There are a number of disorders of the inner ear that lead to dizziness. The most common are neignic paroxysmal positional vertigo (BPPV), acute vestibulopathy (neuronitis of the vestibular nerve), Meniere’s disease, vestibular myrene, labyrinth fistula, labyrinthitis …
Some disorders are associated with hearing loss. Most disorders can be diagnosed with the help of a physical examination and taking a detailed medical history.
Treatment of the disease depends on the cause.
Therefore, in order to be sure of the origin of the balance problem, it is necessary to do balance test tests.
The balance test is adapted to diagnose peripheral balance disorders, and is divided into:
In static tests, spontaneous and visual nystagmus are distinguished. Nystagmus is the appearance of involuntary twitching of the eyeball with the aim of obtaining a stable image. Depending on the degree of nystagmus, the complexity of the disorder can be determined.
The test is quick and easy. The doctor will ask you to fix your gaze on the object (in most cases the finger). After that, he will move his finger to both sides to recognize the twitching of the eyeball.
If twitching occurs while moving the gaze in the direction of the object of observation, it is the first degree of nystagmus. If the eyeball begins to twitch when the object is in the middle, without moving to the side, then second-degree nystagmus occurs.
The most complex is third-degree nystagmus, in which twitching occurs even when your gaze is directed in the opposite direction to the object of observation.
If the eyeball twitches even without a fixed object, it is called spontaneous nystagmus.
Dynamic balance tests focus on examining the vestibulo-ocular reflex, which is stimulated by rapid head movement and observation of nystagmus after the test.
From the dynamic tests we share:
By moving the head quickly from left to right and stopping abruptly, a sudden discharge of energy is induced, looking for the difference between a correct and a defective canal in the inner ear.
Any imbalance would result in eye twitching, i.e. nystagmus. In a healthy person, there should be no nystagmus.
With this test of balance, it is again sought to “provoke” the focus of the eye on one object. During the examination, the doctor will hold your head with both hands and will ask you to fix one object with your eyes (usually the doctor’s nose).
With sudden jerks of the head, the doctor will try to impair your focus. A healthy person should have a focus on the subject throughout the examination.
A scale with letters will be positioned in front of you, from the largest to the smallest. First, you will be asked to read as small a row of letters as you can.
After that, the doctor will quickly move your head left and right and will ask you to try to read the letters again.
If the difference between the read letters is greater than two lines, it is a bilateral peripheral vestibular damage.
This balance test is done when you notice short-term and sudden dizziness when turning around in bed or lifting your head abruptly. Known as benign positional paroxysmal vertigo (BPPV), this disease is considered the most common disease of the vestibular system.
This disease occurs when calcium carbonate crystals are moved in a labyrinth , this can occur in the event of a blow to the head or some other sudden jolt. Once the so-called otoliths are moved, the movement of the endolymph is disturbed, causing problems with balance.
The test is done by turning your head 45 degrees to the side where you notice dizziness. Then you are laid on your back, and your head must be below body level.
The doctor observes possible twitches, i.e. nystagmus that disappears 10-15 seconds after you lie down. After one minute, the doctor straightens you up again and observes changes in the twitching of the eyeballs.
If there is no nystagmus, the person does not suffer from BPPV. If nystagmus has appeared, it is a displaced calcium stone that causes dizziness.
After diagnosing BPPV, the doctor can immediately perform a repositioning maneuver in which he returns the otolith to the place where it was before.
It is performed when the patient cannot stand up, in acute damage, the patient’s outstretched arms turn in the direction of the diseased side of the ear
Orthostatics are examined, the patient stands with his feet close, his eyes closed and his arms outstretched. If there is a balance problem, the body will not be able to stand still.
With your arms crossed and your eyes closed, take 50 steps in place. If the degree of deviation from the starting point is greater than 30 or if it is more than one meter away, the test is positive.
A positive test indicates problems of lesions in the ear labyrinth.
In this balance test, you walk with your foot in front of your feet and with your eyes closed. Depending on the instability while walking, your doctor may diagnose diseases such as bilateral peripheral vestibular damage or cerebellar lesions.
This test is performed by inhaling and trying to exhale abruptly with your nose and mouth closed. If nystagmus occurs, possible damage to the upper semicircular canal is indicated.
The occurrence of nystagmus by pressing on the tragus of the diseased ear or by increasing or decreasing the air pressure in the ear canal using the Politzer balloon indicates the existence of a perilymphatic fistula.
You don’t need to prepare for the balance test. Before performing motor tasks, you will need to fill out forms to assess your own condition.
You fill them out so that, in addition to the tests performed, they have additional insights into your health condition.
Of the forms, you most often fill out:
Balance problems can occur for a number of reasons – mainly it is a combination of innate and external factors. So, for example, you may have congenital problems with the function of the inner ear, but trauma such as a fall or a blow to the head can accentuate these problems even more.
Surprisingly, dizziness problems can also be attributed to poor circulation. Namely, a vertebral artery passes through our spine, which brings oxygen to the head. If circulation is poor, the oxygen supply will be lower and the cerebellum will not be able to perform its function properly.
People who have such problems are often at risk of cardiovascular diseases (high blood pressure, increased body weight, high cholesterol, alcohol consumption, blood sugar…)
To be sure that it is poor circulation and blockage of small arteries, we can additionally order you for Color Doppler of blood vessels.
To understand the balance test, it is first necessary to explain the function and principles by which our body behaves when subjected to such tasks.
The balance center is located in the inner ear and is even better known as the vestibular system. This system consists of sacculus, utriculus and semicircular tubules that are filled with endolymph, a fluid that registers changes in the movement of the organism.
Inside the labyrinth there are receptors that record the movement of the endolymph. Once the receptors detect movement, the impulse travels to the cerebellum. The task of this impulse is to prepare the body for motor tasks appropriate to the situation.
So, for example, by standing on one leg, the inner ear will send a signal to the cerebellum to prepare the body for a change in balance and maintaining this state.
The problem arises when the signals from both ears are different. In this case, two different signals are received and such a circumstance “confuses” the cerebellum – the body loses its balance because it does not know which signal is real and correct.
That is why it is normal for us to feel dizzy if we spin around our axis several times at high speed – the fluid in the cochlea and ducts does not have time to register such changes and the brain receives the wrong signals.
We divide two types of dizziness:
In practice, 90% of dizziness is of peripheral origin. That is why balance tests are adapted to peripheral balance disorders and are performed by ENT specialists. If balance tests indicate problems of the cerebellum, this is further dealt with by a neurologist.
Dizziness caused by standing up suddenly and changing the position of the body is normal. What indicates greater complications is dizziness at rest or the inability to perform basic motor tasks.
This type of dizziness may point to disorders in the function of the inner ear and cerebellum. That is why it is important to conduct a balance test – it provides data that tells us everything about the function of hearing, vision, sense of balance and proprioception (the feeling of movement of one’s own body).
The balance test is part of the ENT examination that we perform at the Lohuis Filipović Polyclinic. Given that ENT is a branch that deals with the observation of the functions of the ear, nose and throat, a balance test is necessary to check the health of your inner ear.
The inner ear, with its cerebellum, form a very complex system in which even the slightest change can disrupt your balance center. Therefore, we carry out these balance tests and remove any doubts about your health.
Make an appointment for an ENT examination today – call us at +3851 2444 646 or fill out our online form.
The main goal of LF Polyclinic is to improve the quality of life and health of our clients by providing them with top-notch healthcare services.
