Balance assessment using Vesticam Video Frenzel Goggles

HOW DO WE ASSESS THE VESTIBULAR SYSTEM?

In our full vestibular testing appointment, we use a battery of several different tests to measure different elements of the vestibular system individually, as well as how it interacts with our brain, eyes and nervous system.

Looking at all the tests together, we can build a picture of the function of the overall system, as well as identifying any weaknesses that may point to a specific diagnosis. This can aid in finding the right treatment for each person.

Our initial assessment appointment uses our Vesticam Video Frenzel Goggles (modelled to the left by Tash), which allow Dion to measure eye movements that are triggered by signals sent to the brain from your balance organ in your ear. See the video to the right to see Tash getting assessed.

The vestibular system

what can be done to help?

The treatment for vestibular issues vary significantly, depending on what issues are highlighted. It may include one or more of the following:

  • Physiotherapy - many vestibular disorders can be treated effectively, either with manoeuvres completed by a physiotherapist or with a tailored exercises programme to be completed at home.

  • Medical treatment – some vestibular disorders can be managed with medication. This is usually prescribed by an ENT specialist or a Neurologist.

  • Surgical treatment – some vestibular disorders can be managed with surgery. The risks and benefits of surgery vary, which is why it is important to have a consultation with a specialist to discuss this option.

  • Psychology – a significant contributor to many vestibular disorders is psychological, and improved mental health can improve physical symptoms. Treatments may include meditation, mindfulness, physical exercise, cognitive behavioural therapy, talking therapy or counselling, among others.

what is the vestibular system?

The vestibular system is the name we give to our balance organ in the inner ear. The vestibular system sends signals to and from our brain to let it know where our head is in relation to our body and objects around us. We rely on the vestibular system to maintain focus on something while moving our head or body.

The vestibular system comprises of three semicircular canals (anterior, posterior, lateral) that measure angular movement in all directions, as well as two otolith organs (saccule and utricle) that measure linear movement. The system also includes the nerve between the vestibular organ and the brain, as well as several key areas in the brain.

Pure tone, speech and immittance audiometry – Tests of the hearing pathway

Cervical Vestibular Evoked Myogenic Potential (cVEMP) – Primarily a test of the saccule

Ocular Vestibular Evoked Myogenic Potential (oVEMP) – Primarily a test of the utricle

Subjective Visual Vertical/Horizontal – A test of the saccule and utricle

Posturography – A test of how the vestibular system integrates with the brain, eyes and nervous system

what testS do we do?

Video head impulse test – A test of all 6 semicircular cana

Electrocochleography – A test of the inner ear’s electrical function

Videonystagmography - A test of the vestibulo-ocular reflex. This assesses how the brain integrates information from the eyes and ears.