Vertigo is a symptom of a number of conditions, rather than a disorder itself. There are two main types of vertigo.
- Peripheral vertigo This is the common type of vertigo, which occurs when there are problems with your inner ear and vestibular nerve. Both of these play a vital role in the body’s ability to maintain balance.
- Central vertigo Less common, this type of vertigo is the result of an illness or injury affecting the brain.
Various tests can help your doctor determine which type of vertigo you have or if your dizziness is related to another health condition. After asking about your symptoms, documenting your health history, and performing a general physical exam, your doctor might suggest one or more of the following tests.
Dix-Hallpike Maneuver
The Dix-Hallpike maneuver is commonly used if your doctor suspects you have benign paroxysmal positional vertigo (BPPV) — the most common cause of vertigo. This method can also help your physician figure out if your vertigo is due to an inner ear problem or another issue.
Your healthcare provider will turn your head 45 degrees to one side. Then, you’ll quickly lie on your back, with your head off the side of the table, and maintain the 45-degree head turn for at least 30 seconds. Your doctor will inspect your eyes to see if they shift involuntarily (a sign of BPPV) and ask if you feel dizzy. The procedure is then repeated on the other side.
You should know that this test could trigger unpleasant bouts of vertigo. If you develop symptoms during this test, your doctor will determine that you do indeed have vertigo.
Head Impulse Test
Romberg Test
For the Romberg test, you’ll be asked to stand with your feet together. First you’ll be assessed with your eyes open and then you’ll close your eyes. Your doctor will examine how much you sway or fall. If you become unsteady or begin to sway only when your eyes are closed, the test is considered positive. This test can help doctors identify neurological conditions like Ménière’s disease.
Fukuda-Unterberger Test
The Fukuda-Unterberger test requires you to march with your eyes closed. Your physician will look at how your body strays from the midline to identify which side of your body is affected by vertigo.
Electronystagmography (ENG) or Videonystagmography (VNG)
ENG and VNG are used to detect abnormal eye movements and determine if vertigo symptoms are caused by an inner ear problem.
ENG uses electrodes and VNG uses small cameras to measure eye movements while your head is placed in different positions or as you’re asked to track certain visual targets. Air or water may also be used to control your ear canal temperature. These tests are usually performed in a dark room and may elicit jerking eye movements.
Rotation Tests
Rotation tests are used to see how well the eyes and inner ear work together. They involve moving the head slowly from side to side while analyzing eye movements. There are different types of rotation tests. You may be asked to sit in a chair that moves from side to side, or to look at a fixed target and move your head back and forth or up and down.
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