Suffering from vertigo is very stressful and severely restricts your quality of life. In order to treat the symptoms correctly and resolve them in the long term, it is essential to find out the causes. Dizziness diagnostics are used for this purpose.
Below you will find further information on the various diagnostic methods as well as specialists and clinics for dizziness diagnostics.
Dizziness can have numerous causes. It is often not an independent clinical picture, but a symptom of another underlying disease. Vertigo diagnostics includes various methods to identify the causes of the vertigo symptoms.
The first step is for the ENT specialist to take a detailed medical history. As the patient, you report any previous illnesses and describe precisely when the dizziness occurs and how exactly it feels. Be sure to also list any accompanying symptoms such as nausea and vomiting or visual disturbances. In most cases, an initial suspected diagnosis can already be made based on the patient's description.
Depending on the suspected diagnosis, the doctor will initiate further examinations. These include, for example
If the doctor suspects a neurological cause, he or she will also order imaging procedures(MRI or CT).
Temporary feelings of dizziness, e.g. after a rollercoaster ride or after standing up too quickly, usually have no pathological value. However, medical clarification by means of dizziness diagnostics is advisable if
The appropriate first point of contact is an ear, nose and throat specialist or a specialist in vertigo medicine.
This specialist distinguishes between two types of dizziness:
In peripheral vertigo, the cause of the symptoms lies with the vestibular nerve or the organ of balance. Central vertigo, on the other hand, is caused by disorders in the brain, e.g. due to circulatory disorders.
The following clinical pictures can therefore be diagnosed with the help of a dizziness diagnosis by an ENT specialist:
We have already mentioned the most important methods of dizziness diagnostics in the introduction, now we want to examine them in detail.
No technical equipment is used in the orientation balance tests. The patient has to complete various exercises that allow the sense of balance to be assessed:
One of the most important diagnostic criteria for a disturbance of the sense of balance is the so-called nystagmus. These are uncontrolled eye movements.
The ability to see is significantly involved in maintaining balance. If the vestibular nerve and/or organ is damaged, the body attempts to restore spatial orientation with the help of the eyes. This is noticeable through twitching.
Caloric irrigation
Caloric irrigation enables a side-separated examination of the peripheral vestibular organ.
The patient wears video goggles that record the eye movements. The auditory canals are then rinsed once with cold and warm water in succession. The change in temperature causes the fluid in the semicircular canals of the ear to move, which in turn triggers a nystagmus to the diseased side.
Vertigo diagnostics check whether the vertigo is caused by a disorder of the vestibular system © Henrie | AdobeStock
Video head impulse test
The video head impulse test is one of the most modern diagnostic procedures. As with the caloric flush, a side-specific test of the ocular reaction (nystagmus) is carried out. In addition, the head impulse test makes it possible to assess all six semicircular canals in less than ten minutes.
The patient wears video goggles that work with ICS impulses. These mimic head movements from everyday life. The results are recorded digitally and monitored by the doctor on a PC.
Ocular and cervical VEMP
The abbreviation VEMP stands for Vestibular Evoked Myogenic Potentials. If the vestibular organs are stimulated acoustically or by movement, various muscle groups react.
In this way, for example, involvement of the saccule (lat. sacculus) can be detected in Meniere's disease. The saccule located in the inner ear is an important component of the static system. If its function is impaired, dizziness attacks occur.
In practice, the VEMP technique primarily involves air conduction stimulation and bone conduction stimuli. The patient wears electrodes and, if necessary, dizziness goggles to record the muscle reactions. The doctor monitors the results using a special display.
The cVEMP or oVEMP findings are also suitable for diagnosing nerve inflammation in the inner ear. The extent of the inflammatory process can also be reliably assessed. The diagnostic procedure also provides information on whether the lower or upper part of the vestibular nerves is affected by damage.
Swivel chair test
Video goggles are also used in the swivel chair test. As the name suggests, the patient sits on a swivel chair and is turned to the left and right for half a minute at a time. The video glasses record the eye movements.
Hallpike test
This test is carried out to diagnose benign positional vertigo. The doctor moves the patient's head and torso quickly in a set sequence. In order to observe the eye movements, it is also useful to wear video glasses.
With the help of modern vertigo diagnostics, the causes of peripheral and central vertigo can be reliably determined. If it is a form of central vertigo, a referral is made to a neurologist.
The modern diagnostic procedures do not pose any health risks. The only risk is that the symptoms of vertigo may temporarily increase during the examination itself. However, this is usually desirable in order to confirm the diagnosis.
In some patients, however, the dizziness diagnosis remains inconclusive. In this case, a psychosomatic cause (psychogenic dizziness) cannot be ruled out. However, it is important to know that those affected are not making up their symptoms. The dizziness is real, but the cause is not physical. In this case, psychotherapy can help.
The prognosis of vertigo symptoms depends largely on the underlying disease. Through
many patients achieve complete freedom from symptoms.
If the doctor has diagnosed a disease of the vestibular nerve or organ, it is particularly important to take it easy physically. Sometimes it is even necessary to stay in hospital for several days in order to administer intravenous medication (e.g. cortisone).
As soon as the acute symptoms have subsided, the patient begins special physiotherapy to train their sense of balance.
Modern dizziness diagnostics includes numerous methods to determine the cause of the symptoms as precisely as possible. A reliable diagnosis is in turn the basic prerequisite for effective treatment.
Do not let your vertigo symptoms go untreated. The sooner a medical diagnosis is made and suitable treatment is initiated, the better the prognosis.
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