Balance Laboratory Investigations (some of the methods we use to identify how severe is the balance problem and what balance systems are causing the symptoms.)
Test of Balance Capacity:
Computer Analysis of :
Image courtesy of Natus Medical Inc.
Dynamic Posturography: Includes changes in stability with head movement at velocities of everyday life.
(Physiologic Velocity): Ability to maintain stability when what you stand on(support surface) or what you see moves.
Image courtesy of: Natus Medical, Inc.
Dynamic Visual Acuity: Ability to see clearly when your head moves at physiologic velocities
Postural Evoked Response: Timing of muscle response to sudden shifts in support surface
Tests of specific balance system sensors:
Computer analysis of :
Stimulation of each semicircular canal: (anterior, posterior, lateral) at speeds that occur in everyday life (physiologic velocities) (Physiologic Heat Thrust)
See Video
Utricular function:
Centrifuge: stimulation of each side’s utricle with measurement of visual vertical and eye torsion.
Ocular Vestibular Evoked Myogenic Potential: sound stimulus of each side’s utricle with measurement of eye muscle response.
Saccular Function:
Cervical Vestibular Evoked Myogenic Potential: sound stimulus of each side’s saccule with measurement of neck muscle response.
Central(Brain) Function:
Rotary Chair: Evaluation of phase of vestibular ocular reflex (VOR)and of time constant.
Image courtesy of: Neuro Kinetics, Inc.
VOR with fixation and with enhancement
Response of slow and fast phase of eye movement to optokinetic stimulus
Presence of Optokinetic After Nystagmus
Video Nystagmography:
Evaluation of cervical nystagmus
Transtympanic electrocochleography
Evaluation of Volume status of endolymph and indirectly integrity of closure of inner ear fluids.