Dizziness & Balance
Much of the diagnostic clues about vertigo is picked up by your doctor based on the history of your symptoms and the findings of a physical examination. During this exam, your doctor will check how the major nerves of your central nervous system are working, how you maintain your balance and how you coordinate your movements.
The specific tests which your doctor may perform include
- Eye movement testing. The path of your eyes is observed as you track a moving object.
- Head impulse testing (HIT). Your doctor will ask you to focus your eyes on a fixed target. As he guides quick and small movements of your head using his hands, he observes if you are able to make the appropriate and coordinated response to maintain your visual focus.
- Positional Testing. If your doctor suspects your vertigo is caused by benign paroxysmal positional vertigo (BPPV), he or she may do tests of your head in different positions (usually involve bending or lying down with the head in different but specific positions) e.g. the Dix-Hallpike or Log Roll manoeuvre. It is important for you to know that you might experience severe vertigo for a short time when these tests are performed. However, this allows your doctor to make the right diagnosis and therefore to perform the right particle repositioning manouevre which may help you to recover in the quickest possible time.
If your doctor suspects you are having or may have had a stroke, or if you have suffered a hit to the head, he or she may order an MRI or CT scan. However, this is an uncommon scenario for patients attending a consultation at the outpatient clinic.
You may be asked to undergo blood tests to check for other conditions which may sometimes be related to vertigo e.g. chronic infection, autoimmune diseases, thyroid disorders and diabetes mellitus.
As the balance and hearing components of the inner ear are intimately related, most patients will be asked to undergo a hearing test to screen for any impairment of the hearing system as well. Based on the results of your hearing test, your doctor may then decide on whether other investigations are needed e.g. MRI scan and/or blood tests.