| Testing Procedures and Information | |
| Things
to remember prior to testing DO NOT take any of the following for 48 hours prior to testing: 1.) No alcoholic beverages 2.) No cold remedies (i.e. NyQuil) or medications for the control of dizziness or motion sickness (i.e. Antivert, Meclizine, Bonine.) 3.) No tranquilizers, sleeping pills, muscle relaxants or pain pills. Patients having Rotary Chair or VNG testing should not eat more than a light meal one hour before testing. Ladies please DO NOT use facial lotions or make-up prior to testing. Please call our office at (907) 561-2102 if you have any questions
regarding test procedures or if you need to cancel your appointment.
The movements of your eyes are coordinated by your brain to allow for clear vision while you are actively moving (such as during exercise) or passively moving (such as when sitting in a moving car.) Since vision helps you maintain balance, measuring the direction and amount of eye movement will indicate if there are any weaknesses in your balance system in one or both ears. For this test, you will lie on an exam table. Video goggles will be placed on your head in order to record and analyze your eye movement. The goggles measure activity from your body and will cause little or no discomfort. The test will evaluate your eye movements as they follow a moving target, and as your head is positioned in a different direction with your eyes opened. Another series of tests, the caloric tests, evaluate the inner ear response as warm and cold air are circulated through your inner ear canal. Changes in temperature stimulate your inner ear and cause eye movement. VNG testing helps detect if one ear is more affected than the other. A difference from one ear to the other can cause balance problems. VNG testing can also detect lesions and, on rare occasions, tumors. VEMP Test While sound is being transmitted, the patient will lift their head off the table. The electrodes meansure the response of the balance nerve. The test is completely painless, safe and one of the most modern available. the VEMP test is fully computerized and results are interpreted by the doctor. This test measures the interrelationship of all three primary sensory systems of your balance system: your eyes, muscles and joints and inner ear. The test gives objective information to determine whether or not your balance problems are due to an individual sensory deficiency or a combination of them. During the test you will stand without shoes on a platform surrounded on three sides by walls. You will wear a safety harness that will catch you if you loose your balance during testing. The clinical technician is there to assist you and is operating the computer as you complete your test. The computer will make small controlled movements of the platform and walls while recording data on how your body makes adjustments to maintain your balance. This data is analyzed by a physician to determine if one or more parts of your balance system are abnormal. The posturography test helps your doctor determine the cause of
your balance problem and any changes in your condition such as inner
ear problems, aging, strokes, cerebellar degeneration, cerebral
palsy and head injury. It also helps determine areas that need more
investigation and determining if a treatment has been successful. ECOG Test The ECOG (electrocochlieography) test is a complex test designed to record the electrical activity of the cochlea, a part of the innner ear. It is performed by placing an electrode, followed bu a speaker into the ear canal close to the eardrum. The ear is then stimulated with clicks or tone bursts. These tone bursts are transformed into vibrations in the middle ear and are recorded and measured with the electrode and special computer software. The objective is to measure and confirm the increased pressure present due to excess fluids in the inner ear. The pressure test will help determine if a tiny opening (a perilymphatic fistula) between the middle and inner ear is affecting the function of your vestibular system, causing symptoms like dizziness, nausea, headache and/or hearing loss. During this test, the air pressure in your external ear canal is changes while you are standing on a moving platform with your eyes closed. An ear plug is gently inserted into your ear canal. The air pressure in the external ear is changed through this process, causing a corresponding pressure change in the middle ear. Changes in pressure outside the body do not normally cause vestibular responses since the inner ear is sealed. However, if a fistula is present, the vestibular system in the affected ear will be stimulated, causing certain postural changes and body sway which are recorded by the computer. VAT Test This test measures vestibular ocular reflex (VOR.) The VOR stabilizes images when we move. Normally when we turn our head our head and our eyes move the same number of degrees in the opposite direction. This is how we accommodate movement. Electrodes are places around the eyes. Using the sensors the comptuer records eye and head motion as the patient moves the head (in time with a pre-recorded sound) while attempting to keep the eue focused on a dot on the wall. The test starts with slow side to side movements and progresses to quicker and shorter movements, and ends with very tiny movements back and forth. When the head is moved the brain sends a message to the eyes and ears. The test measures distance and timing (degree) of eye movement and head movement. Rotation of the head stimulates the inner ear and visual system which causes a reflexive eye movement called nystagmus. Nystagmus is useful because it allows you to maintain clear vision as your head moves. The rotary chair tests for abnormalities of this eye-head movement reflex and identifies problem areas in the central part of the brain stem. A series of tests are performed while you sit securely harnessed into a computer-controlled chair in a small, darkened room. Sensors will be placed on your forehead and beside each eye to record eye movement as the chair turns gently from left to right. A microphone and speaker in the testing room allow you to speak
with the technician, who is seated at the computer console just
outside the door. Therefore, if you become uncomfortable, you will
be able to tell the technician, who will stop the test until you
are ready to proceed again. Assessment begins by observing the patient perform tasks that evaluate both static and dynamic control of their center of gravity. The results indicate the patients degree of balance dysfunction and assist in establishing concrete goals for therapy. With the patient's balance capabilities known, a training program is then designed to treat specific problem areas. The treatment plan challenges the patient with multiple exercise
tasks that are each focused on a specific balance deficit. This
will include exercises and activities to be performed both in clinical
therapy and in their home. |
