![]() Frenzel Lenses (left) are shown alongside a laptop computer with a recorded image of both eyes. The following are some useful questions and their rationales:įigure 1. Dizziness questionnaires (such as Dizziness Handicap Inventory or DHI) are often useful as a “starting point” to identify and probe specific situations and concerns. Prior to vestibular assessment, a comprehensive case history should be obtained, including when their dizziness signs and symptoms started, how long they lasted, when the last event occurred, as well as the patient’s description of the event, and more. Therefore, this article proposes an efficient, effective, and low-cost screening protocol for the hearing care professional to consider with regard to the initial evaluation of the “dizzy” patient, and to help triage, document, and refer (as needed) these same patients. Pragmatically, experts with state-of-the-art equipment are not always available and may not be the first person to evaluate and diagnose these patients. ![]() To efficiently and effectively diagnose and treat dizziness, clearly the best option is to have expert audiologists and a sophisticated vestibular laboratory (ENG, VNG, VEMP, Rotary Chair, VAT, CDP and more) available. Beck, Petrak, and Bahner 2 reported “Vestibular disorders in children are often under-diagnosed, and vestibular disorders are more common in children with significant hearing loss and other inner-ear abnormalities.” Some patients experience a single episode of vertigo, while others may present during an acute stage of labyrinthitis some present with positional vertigo and can be treated in the office.Įquilibrium problems reach beyond the adult population and may manifest as “balance problems” in infants and children, rather than “vertigo” or “dizziness.” Gans 1 reminds us that children have “audio-vestibular systems,” not just auditory systems congenital or acquired deficits may impact the entire audio-vestibular system. Balance problems negatively impact virtually every aspect of the patient’s life. If one of the vestibular organs is weak or impaired, the brain senses a mismatch, resulting in dizziness.ĭizziness is a catch-all term for numerous symptoms, ranging from subjective to objective vertiginous sensations (ie, the person feels they are spinning or senses the room is spinning, respectively), to “light-headedness” to weakness while rising from a sitting position, and everything in between. In a healthy vestibular system, when the left side of the vestibular system sends excitatory information to the brain, the right side sends an equal amount of inhibitory information to the brain. The left anterior SCC is paired with the right posterior SCC, the left posterior SCC is paired with the right anterior SCC, and the left and right horizontal SCCs are paired. To maintain balance, the brain relies on equal-but-opposite (ie, paired) input from the left and right semi-circular canals (SCC). ![]() The balance system also indicates whether we’re moving and in which direction relative to our surroundings, and which counter-or-corrective action is required. Healthy balance systems rely on complementary and accurate sensory input from vestibular, vision, and somatosensory systems to perceive and interpret the individual’s location with regard to gravity, the horizon, and space. Beck, AuD, is director of professional relations at Oticon Inc, Somerset, NJ. Amanda Smith, AuD, is director of audiology at Lakeside Physicians in Granbury, Tex Michelle Petrak, PhD, is director of clinical audiology at Interacoustics A/S in Assens, Denmark Cammy Bahner, MS, is senior clinical audiologist at Interacoustics US in Eden Prairie, Minn and Douglas L. ![]()
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