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Balance

Balance disorders are a major health concern for all ages.

The most common complaint causing significant anxiety and reduction in quality of life is BPPV (Benign Paroxysmal Positional Vertigo). This can be swiftly diagnosed and treated with more than 90% success. Many patients are treated with long term medication at high cost when vestibular rehabilitation or surgical treatment can provide complete resolution of symptoms.

Sussex Audiology Centre and Dr Rob Low DPhil. can offer a comprehensive balance assessment service (Consultant referrals only) using the latest equipment and techniques to fully assess balance problems and find practical solutions to help restore confidence and an active lifestyle. Dr Rob Low is a highly regarded Audiological Scientist specialising in balance disorders and can select a range of appropriate balance assessments to help assist in the diagnosis and treatment of dizziness and vertigo.

It is important that an ENT Consultant Surgeon or Neuro-Surgeon has been consulted first to ensure that the procedures are medically safe and in order to work collaboratively to reach a successful diagnosis.

Some of the diagnostic testing carried out at Sussex Audiology Centre are;

Videonystagmography (VNG)

This has become the standard tool for investigation the function of the central balance system such as the cerebellar and brain stem contributions. We use a VNG system from Synapsys developed in France which records eye movements using an infra-red camera so that there is facility for computer analysis and for playback for slow motion analysis of complex anomalous eye movements. An important benefit of the Synapsys system is the lightweight goggles used. This provides far greater freedom of movement for our patients, which is very important in positional testing. As the goggles are extremely simple to set-up and very comfortable to wear by your patients, this all makes testing a great deal simpler than alternative or older electrode based systems.

Calorics

Sussex Audiology Centre uses an air caloric system compliant with BAA regulations for airflow rate and with intrinsic otoscopy to allow accurate delivery of the precisely set temperatures of air stimulus. Air calorics are far better tolerated than historic water caloric systems, which have developed notoriety amongst patients for the adverse experience that they created. The nystagmic responses induced by the calorics are once again analysed using the infra-red camera and Synapsys system. The caloric test is one of a few objective tests of balance organ function which remains fundamental to the assessment of the balance dysfunctional patient.

The Dix–Hallpike

The Dix–Hallpike test is a diagnostic manoeuvre used to identify benign paroxysmal positional vertigo (BPPV) The Dix-Hallpike test camera allows recording of eye movements induced by the procedure for later analysis in order to determine whether vertigo is triggered by BPPV in one of the six semi-circular canals or by a central brain disorder.

The Epley manoeuvre

The Epley manoeuvre is used to treat benign paroxysmal positional vertigo (BPPV) of the posterior or horizontal canals. Free floating particles from the affected semi-circular canal are relocated, using gravity, away from the sensitive copular region to remove symptoms immediately.

Vestibular Evoked Myogenic Responses (VEMP)

This is an emerging test, which tests either saccular function (cervical VEMPs), or utricular function (oVEMPs). The stimulus is a loud sequence of sound bursts delivered through a headphone and surface electrodes record the response which can be used to diagnose a range of complaints from Menieres disease to superior semi-circular canal dehiscence. Dr. Low has published current research in the diagnostic use of VEMPs and is a leading expert in this form of assessment.

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