The Section of Vestibular Disorders provides a comprehensive multi-specialty approach to the diagnosis and treatment of vestibular disorders and balance problems.
The balance system is complex and depends on the integration of visual, inner ear, and sensory information from the joints and muscles. The central nervous system integrates this input and directs the body to maintain balance in relation to the demands of the environment.
Many vestibular disorders and problems affecting the vestibular and balance system can be diagnosed with a complete history and physical exam with one of our specialized physicians. When coming for an appointment, patients are asked to bring any records of previous evaluations including physician’s notes, audiograms (hearing tests), vestibular testing, and physical therapy findings. The actual films of prior neuroimaging studies of the brain and/or neck are reviewed, as well as reports from those studies. Patients complete questionnaires about the severity of their dizziness and their overall medical history.
Patients with vestibular disorders should wear comfortable clothing, since the examination will likely involve some reclining and moving from side to side. Special glasses equipped with tiny, infrared cameras to record eye movements may be used to help measure the function of the balance system during these movements.
Additional testing may be suggested by the physician if the nature of the problem cannot be determined at the initial visit. Two computerized facilities at Cleveland Clinic allow complete vestibular testing to be done rapidly and include tests that evaluate the ability of the inner ear to respond to rotational and positional cues (the visual component of the balance system) and the ability of the brain to combine visual, inner ear, and muscle and joint information from the neck. Hearing evaluation and neural imaging studies, such as magnetic resonance imaging, can be done, if needed for dizziness or vertigo treatment. Vestibular disorder treatment plans can be formulated for implementation on-site or at home, if patients come from a distance.
Symptoms that bring patients to the vestibular disorders section include vertigo (the illusion of movement), disequilibrium, staggering, and lightheadedness. Fainting or loss of consciousness is not usually related to the vestibular and balance system. Hearing loss may be an associated symptom. Some of the common disorders diagnosed and treated in the section include:
- Benign positional vertigo or BPV, which can cause brief, intense vertigo reproducible with position change.
- Meniere’s disease, which is an association of more prolonged episodes of vertigo with fluctuating hearing loss.
- Labyrinthitis, which is a viral inflammation of the inner ear causing vertigo lasting for weeks with associated hearing loss.
Additional areas of expertise include migraine-associated dizziness and the cardiovascular system’s interaction with the vestibular system. Active research areas include studies and evidence-based reviews of vertigo treatment and new diagnostic options and for vestibular disorders.
The multidisciplinary team includes audiologists, nurses, vestibular testing technicians, and physical therapists trained in specific vestibular disorders and balance therapy techniques. Since the section is located within Cleveland Clinic, rapid access to consultation from many other specialists, such as cardiologists, rehabilitation specialists, and surgical neurotologists, is available, if needed.
Please feel free to contact our office prior to your evaluation if you have questions about what to bring or about medications, or if you are coming from a distance and would like the assistance of our medical concierge service in coordinating the details of your visit.