Diagnosing Vestibular Problems

What Do We Test for in a Clinical Evaluation of Dizziness?

Before going into actual vestibular tests, it is important that Vestibular Rehabilitation Therapists take a thorough history and perform some safety checks to make sure that your dizziness is not potentially due to something that should be looked after by a Doctor.

When we ask about your history, we will want to know things like:

• When your symptoms started;
• Whether they were insidious ("out of the blue") or related to an incident or illness;
• If there were other symptoms than just dizziness, i.e. nausea/vomiting, hearing changes, vision changes, headache, numbness/"pins and needles", unsteadiness;
• The nature of your initial and current dizziness, i.e. lightheadedness, disorientation, feeling "off", "room spinning";
• The duration of your initial and current symptoms: seconds, minutes, hours, days;
• What increases or decreases your symptoms, if anything;
• Other medical conditions you are dealing with, medications, previous experiences with dizziness and family history.

Safety Checks in Initial Dizziness Screening Help to Identify any Medical Concerns

The safety checks we perform in our initial screening include:

1. Checking the mobility of your neck, and, if there has been trauma or rheumatoid arthritis, stability of the ligaments in the upper part of the neck;
2. Checking if certain neck positions produce signs or symptoms suggesting compromise of the blood flow through the neck to the head;
3. Performing tests to see if some of the control centers in your brain (cranial nerves and cerebellum) appear to be working properly;
4. If indicated by your history, blood pressure testing including a comparison between lying down and standing.

If there are concerns from your history or the testing above that your Doctor is not aware of and has not investigated, we would refer you back to your Doctor for further testing. In some instances we would put further testing and treatment on hold until your Doctor has seen you, and in other cases, we can proceed while you are awaiting further work-up by your Doctor.

Feel free to contact us – we are here to help you!