Vestibular examination: when to do it and how is it done? : Current Woman Le MAG

Understanding how the vestibular examination is performed can help patients obtain an accurate diagnosis and receive appropriate management for their balance disorders.

1. What is a vestibular examination?

As defined by the Academy of Medicine, a vestibular exam is a medical procedure used to assess balance disorders and problems related to the inner ear. There are several types of vestibular examinations:

  • Complete videonystagmographic examination (study of saccades and ocular pursuit, pendulum tests on a rotary chair, caloric tests).
  • Audiometry measures hearing and stapedial reflexes.
  • Caloric testing thermally stimulates the inner ear to assess ocular responses.
  • The eye impulse test observes eye movements in response to head movements.
  • Electronystagmography (ENG) records eye movements during different tests, thus making it possible to analyze vestibular responses and abnormalities.

These exams provide valuable information for diagnosing and treating vestibular disorders.

2. Indications for a vestibular examination

As the information site on vertigo and its treatments specifies, indications for a vestibular examination are many. Indeed, certain symptoms or risk factors may justify their realization:

  • Dizziness and lightheadedness that manifests as a sensation of rotation or movement of the environment, a feeling of imbalance or spinning, triggered or aggravated by head movements.
  • Imbalance and instability when walking or changing position.
  • Nausea and vomiting that are associated with movement, such as rapid turning of the head, going up or down stairs, or taking transportation.
  • A history of vestibular disorders may be an indication for a new vestibular examination to assess the progress of the condition or the appearance of new symptoms.
  • Head trauma such as concussions, as well as injuries to the inner ear can damage the vestibular system and lead to balance disorders.
  • The use of certain medications, such as certain antibiotics or chemotherapy drugs, can have toxic effects on the inner ear and cause vestibular disorders.
  • Some underlying diseases, such as Ménière’s disease, characterized by recurrent vertigo, hearing loss and tinnitus, or vestibular neuritis, inflammation of the vestibular nerve, are directly related to vestibular disorders.

3. The course of the vestibular examination

Before proceeding with the vestibular examination, certain preparations may be necessary. The patient can receive advance information about the examination, including the procedures that will be performed and any sensations they may feel. The patient may also be asked to stop taking certain medications that could interfere with the test results. The vestibular examination usually takes place in a doctor’s office or specialized clinic. Depending on the type of vestibular examination, different stimuli and techniques can be used. For example, during a caloric challenge, hot and cold water is introduced into the ear to elicit vestibular responses. During an eye impulse test, the patient may be asked to perform head movements, while eye movements are observed carefully.

4. Duration and results of the vestibular examination

The duration of the vestibular examination may vary depending on the type of exam, as specified by the Rothschild Foundation. Some exams may take a few minutes, while others may take longer. Once the data is collected, the results of the vestibular exam are usually analyzed by a health care professional who specializes in balance disorders. The results can provide information on the state of the vestibular system, ocular responses and any abnormalities detected. These results help to make an accurate diagnosis and to develop a treatment plan adapted to the patient’s condition.

Sources:

medical academy, Information site on vertigo and its treatment (medical team from the ENT department of the Salpetrière Hospital (APHP) and the CNRS UMR 9010 — Paris Descartes University and ENS Paris Saclay 4), Rothschild Foundation

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