Balance Test and Therapy in Greenville, SC

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Common Balance Disorder Symptoms

Inner ear balance issues produce two types of symptoms:

Motion Intolerance
Even when you are sitting or reclined, dizziness (an overall feeling of imbalance), or vertigo (the sensation that you’re moving or your surroundings are spinning) can occur whenever you move your head or turn too quickly. These symptoms can come and go rapidly or continue for several hours at a time.

Imbalance or Unsteadiness
Feeling unsteady when you get up from a chair, difficulty walking, or unsteadiness on your feet associated with any form of upright movement are symptoms of an inner ear balance disorder as well.

A woman suffering from dizziness trying to steady her balance
Man suffering from imbalance holding a wall to avoid falling

How Is a Balance Disorder Related to Your Ears?

Coordination between three of your body’s systems, including: cues from your visual system, orientation information from your vestibular system, and your proprioceptive system (sensory input from muscles and joints) is necessary to help you maintain your balance. Dizziness and balance problems result from a disturbance or malfunction in one or more of these systems.

Your vestibular system is located in the inner ear, which is able to detect movement and changes to the positioning of your head and/or body. The vestibular system works in a similar way to the bubble in a carpenter’s level as the fluid within the three semicircular canals of the inner ear moves up, down, or side-to-side in relation to the movement of your body. As the fluid moves, it interacts with hair-like cells, which send signals to the brain regarding the positioning or orientation of your body.

Dizziness, vertigo, nausea, and imbalance occur when the vestibular system becomes damaged or malfunctions. Though more prevalent in the elderly as the inner ear systems begin to deteriorate, balance disorders can affect people of any age due to disease, syndromes, toxins, or trauma.

3 Common Balance Disorder Causes

Benign Paroxysmal Positional Vertigo (BPPV)

When calcium carbonate, otoconia, breaks off and migrates into one of the semi-circular canals from the utricle, the result is benign paroxysmal positional vertigo (BPPV). The displaced otoconia interrupt the normal movement of fluid inside the semi-circular canals, which results in false signaling and the sensation of vertigo. Though BPPV is more common in older adults, it can also affect younger individuals, especially after a head injury.

Motion Sickness or Mal de Débarquement Syndrome (MdDS)

MdDS is a neurological disorder related to the signaling function of your vestibular system. Often referred to as motion sickness, you may continue to feel as if you are rocking, swaying, or moving after riding in a car, boat, plane, or exercising on a treadmill even though you are no longer engaged in those activities. Confused by the false signaling, your brain overreacts to the sensation of motion, which leads to dizziness, vertigo, nausea, and imbalance.

Vestibular Migraines

Though most migraines are typically associated with an intense headache, vestibular migraines are a neurological disorder that lead to dizziness, vertigo, nausea, eye pain, changes to vision, and balance disorders. Vestibular migraines are strongly hereditary, affecting 1 in 4 women and 1 in 6 men. Vestibular migraines can also be a symptom of BPPV, Méniére’s disease (an increased pressure in the inner ear), and Transient ischemic attack (TIA), or “mini-stroke.”

What to Expect During a Balance Test

Many patients who might benefit from balance testing and balance therapy hesitate because they don’t know what takes place during a balance test. To help ease your mind, here is what you can expect during your balance assessment.

Legs walking on steel pipe with balance

Before Your Assessment

Though you don’t have to restrict your diet like you do with other types of laboratory tests, in order to get the most accurate information from your balance test, we ask our patients to follow some simple guidelines before their appointment, such as:

  • Refraining from drinking alcohol during the immediate 24 hours before your test.
  • Avoid wearing mascara, eyeliner, or facial lotion when you come for testing.
  • Arriving 15-minutes before your appointment time so you can settle in and be at ease before starting the tests.


ENG/VNG, VEMP test at Upstate Hearing Aid

Balance and Vestibular Tests

Our doctors of audiology have several advanced technology tests available to them to use during a balance assessment. Though they might not use all of them, those often included are:

  • ENG and VNG Tests. Electronystagmography (ENG) uses electrodes to record eye movements while videonystagmography (VNG) tests use small cameras to record eye movements. This helps us evaluate how your visual system is coordinating with your other balance systems.
  • Rotary Chair Test. For this test we’ll seat you in a motorized chair that swivels from side to side and rotates at a controlled rate. This helps us measure the severity of your dizziness caused when viewing moving stripes and also measures nystagmus (involuntary eye movement) during rotation.
  • Computerized Dynamic Posturography. Standing on a force-sensing surface with the support of a harness, CDP tests evaluate which parts of your body’s balance system you rely on most while being subjected to a movable visual surround. This helps us understand how well your inner ears, eyes, and the body’s muscles and joints work together to help you remain in balance.
  • VEMP Test. Vestibular evoked myogenic potentials (VEMP) tests involve attaching sensor pads to your neck, forehead, and under your eyes so we can measure each minute muscle contraction as you react to sounds. VEMP testing helps identify vestibular lesions that can contribute to balance issues.
  • Video Head Impulse Test (vHIT). Your audiologist might use vHIT to measure your vestibulo-ocular reflex (VOR). When your VOR is working properly, head movements are accompanied by equal and opposite eye movements. Limited reactions allow us to pinpoint the cause of your imbalance.


Balance Disorder Treatments

Canalith Repositioning

Canalith Repositioning (used to treat BPPV) helps remove the otoconia from the semicircular canal and return them to the utricle where they belong. Treatment takes only minutes and is successful in treating 95% of patients with no more than 3-4 treatments.


Prescription medications, such as Beta-blockers, Calcium channel blockers, Tricyclic antidepressants, Serotonin or serotonin/norepinephrine reuptake inhibitors (SSRIs or SNRIs), Topiramate, and others can be used to help with dizziness, vertigo, or motion sickness related to MdDS.

Vestibular Rehabilitation Therapy (VRT)

VRT, or vestibular rehabilitation therapy, is the most common form of balance therapy used in balance treatment. VRT involves manual head maneuvers and/or a progressive program of exercises designed to decrease the symptoms of vertigo and dizziness, help overcome visual issues, and protect patients against falls related to imbalance.

Hearing Aids

For those with hearing loss due to damage or deterioration in the inner ear, hearing aids often provide a solution that improves both hearing and balance. In fact, those who wear hearing aids demonstrate a measurable advantage over those with hearing loss who do not use hearing aids when it comes to keeping their balance.

Other Treatment Options

For those experiencing vestibular migraines, changes to diet, lifestyle, and various types of activities can also help prevent or limit the number and/or intensity of migraine episodes.

Schedule a Balance Test

Vertigo, dizziness, and balance problems can have a severe negative impact on your quality of life, ranging from an inability to go about daily living tasks and enjoying an active social life to critical injuries from balance-related falls if left untreated. Getting help for balance disorders from the doctors at Upstate Hearing Aids before they get worse is critical to your overall health and wellbeing.

By completing and submitting the adjacent form, you can get in contact with a balance specialist at our Greenville, SC hearing center to schedule a balance assessment and begin to receive the treatment you need to address dizziness and balance disorders.

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