The Balance Center at the Midwest Ear Institute
The Balance Center at the Midwest Ear Institute was the first of its kind in Indiana. It is a medical facility for the diagnosis and treatment of individuals with dizziness and balance disorders. Patients who may benefit from referral to the Balance Center include individuals with dizziness, balance problems and vertigo due to an inner ear problem or other neurologic problems.
Those who may benefit from a referral to the Balance Center include individuals with:
- Vertigo or dizziness, whether acute or chronic
- Vertigo or dizziness accompanied by hearing changes, sounds in the ears, or headaches
- History of one or more falls due to vertigo or dizziness, especially in the older adult
Dizziness is a symptom that can vary from mild unsteadiness to a severe whirling sensation accompanied by nausea and vomiting. It is a disturbance of the balance system which can be caused by a variety of diseases or underlying problems. The treatment of dizziness depends on its cause(s) and may consist of medicine, surgery, counseling, and/or rehabilitative measures. After a diagnosis is made, patients can be managed with a wide variety of medical, surgical, and/or rehabilitative treatments.
The goal of the Balance Center is to work together with the patient, family, primary care clinician and other health professionals in order to return the patient to a maximum level of activity. Patients with vertigo and imbalance are diagnosed and treated effectively in the most cost-efficient manner possible. Patients may be referred by their primary care provider or specialist who has determined that an otologic consultation is the next logical step in the evaluation of their imbalance.
In addition to specialized skills, our team has access to advanced diagnostic and treatment equipment, including audiometry, videonystagmography, electrocochleography, auditory brainstem evoked response, and vestibular evoked myogenic potential.
Some of the specific dizziness disorders we diagnose and treat include: Ménière’s Disease, Benign Paroxysmal Positional Vertigo (BPPV), Labyrinthitis, and Migraine-Associated Dizziness.
For further help, call the Midwest Ear Institute to learn about our services, who we treat, and how we can provide solutions for your dizziness problems at our Balance Center.
What to Expect from Your Evaluation
The first step in evaluating your balance problem is for your primary care physician or other specialist to refer you for an appointment with one of our otologists–physicians who specialize in disorders of the ear, hearing, and balance. Please bring with you any records and previous test results from other medical facilities. To diagnose your balance and dizziness problem, our physicians undertake a multifaceted approach. First, they will conduct a comprehensive history focusing on balance and dizziness symptoms. Next, they will perform a thorough physical examination including tests specifically designed to assess your balance mechanisms. Finally, as necessary, our physicians may direct additional hearing and balance tests to aid in diagnosing the cause of your dizziness symptoms. Most balance tests are performed at the main office of the Midwest Ear Institute at 7440 N. Shadeland Avenue, Suite 150, Indianapolis, IN. Our staff will schedule these tests and inform you of any special preparation. When the test results have been received, the physician will consult with you in order to convey the diagnosis and proposed treatment. Additional follow-up appointments are scheduled as dictated by your symptoms and response to treatment.
General Test Preparation
Auditory Brainstem Evoked Response (ABR)
This is a computerized hearing test that measures the responses of the hearing centers from your ears to your brain. You will sit or lie on an examination table with earphones in your ears and electrodes will be placed on your head. You will hear a series of clicking sounds. Your brain’s response to these sounds will be analyzed by the computer. This test is painless and will take approximately one hour. There is no special preparation for this test.
Vestibular Evoked Myogenic Potential (VEMP)
This test assesses a different portion of your balance system than does VNG. You will lie on an exam table and electrodes will be applied to your forehead and to the sides of your neck below your jaw. You will listen to a series of clicks through headphones. This test takes 30-45 minutes. Special preparation for men: Neck must be clean-shaven for electrodes to stick.
Electrocochleography (ECoG)
This test assesses a different portion of your hearing & balance system. You will hear a series of clicking sounds and the computer will analyze your brain’s response to the sounds, as in the ABR test (described above). This test is painless and will take approximately one hour. There is no special preparation for this test.
Videonystagmography (VNG)
This objective test of your balance function can help determine the degree and location of a problem with your balance system. You will lie on an examination table and electrodes will be placed on your face. You will be asked to follow the movements of lights on a bar. Your balance system will be gently stimulated by position changes and by the introduction of cool and warm air into your ears. Your responses will be analyzed by the computer. This test will take approximately 1 1/2 hours. You may get dizzy during this test but usually it will quickly pass. We advise that you have someone available to drive you home after this test.
Preparation for a VNG:
24 hours before the test: Stop taking medications such as sleeping aids, tranquilizers, sedatives, narcotics, cold medicines, antihistamines, or dizziness medications. This includes medications such as Allegra, Benadryl, Claritin, Dalmane, Hismanal, Halcion, Robinul, and Xanax. NOTE: You must be off Antivert (meclizine) and Valium (diazepam) for 5 days before this test. Be sure to take medications for other medical problems such as heart disease, blood pressure, circulation, diabetes, epilepsy, etc. Also avoid caffeine (coffee, tea, cola, chocolate) and alcoholic beverages. Decaffeinated beverages are fine.
Day of the test: Avoid smoking. Do not wear makeup, including mascara.
3 hours before the test: It is best if you do not eat or drink anything but if you must, have only a light snack with water.
Sinusoidal Vertical Axis Rotational Testing (Rotary Chair)
This test evaluates the balance system and tells us whether one or both ears are properly functioning. It is helpful in determining the initiation of treatment. You will sit on a computer-controlled rotating chair in a dark enclosure with your eyes open. This test takes approximately 30 minutes and is often done at the same session as a VNG. Preparation for the rotational chair test is the same as for a VNG (see above).