Dizziness and imbalance likely has a definite cause — and a real solution. To determine or confirm what is causing your problems, as well as the best way to help improve your symptoms, you may go through one or more of a variety of tests:

Electronystagmography/Videonystagmography (ENG/VNG): This is the standard for measuring the vestibular system (balance portions of the inner ear, nerve, and brain). It allows us to compare each inner ear, and identify any differences in function between the two sides. It is often used in combination with other tests. (The ENG is not appropriate for infants, small children, or anyone with a hole in the eardrum.)

Rotary Chair Test: This test provides another means of assessing inner ear function and is often better tolerated than the ENG because testing occurs at higher, more natural frequencies. Rotary chair testing can be used to test patients of all ages, including infants. In this test, you sit in a chair and specialized video goggles with infrared cameras measure eye movements as the computer-driven chair rotates gently back and forth at several acceleration rates.

Computerized Dynamic Posturography (CDP): This test assesses your balance and stability under changing support surfaces and visual environments that reflect the challenges of daily life.

Audiometric (Hearing) Test: Your doctor may order basic hearing tests, as the hearing and motion sensing parts of your inner ears are sometimes both affected by the same disease.

Brainstem Evoked Auditory Response (BSER/ABR): Brainstem Evoked Auditory Response testing, allows assessment of the entire auditory pathway up through the bainstem. It is helpful in the identification of retrocochlear causes of dizziness.

Vestibular Evoked Myogenic Potential (VEMP): This simple, noninvasive test provides information about the saccule, an inner ear balance organ, and the inferior vestibular nerve. It is based on a reflex that occurs between the saccule and a muscle in the neck.

Cochlear Hydrops Amplitude Measurement Procedure (CHAMP): This modified BSER test allows for identification of an inner ear condition called cochlear hydrops, also known as Meniere's disease.

Vestibular Therapy Evaluation: A vestibular therapist will do a comprehensive exam to determine your particular functional impairments and if you could benefit from vestibular rehabilitation. Vestibular rehabilitation includes adaptation and habituation exercises, balance retraining, positioning maneuvers, fall avoidance strategies, and home safety guidelines aimed at treating and coping with imbalance and dizziness.

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