Balance Evaluations


The Balance and Dizziness Clinic at Harmony Medical Center is a collaborative team approach by Dr. Kimberly Hoffman of Advanced Audiology & Hearing Care and Brian Prell, MSPT, RRT of Rehabiliation and Peformance Center for the thorough assessment and treatment of balance related disorders.  This state of the art facility including the most sophisticated Videonystagmography (VNG) and Rotary Chair tests in the state of Georgia.  This extensive equipment comprehensively evaluates the balance system to help us determine the cause of the dizziness or vertigo.   We are thrilled to have this caliber of diagnostic equipment in our clinic coupled with personalized and specific treatment plans of balance rehabilitation to help patients with vertigo and non-vertigo related dizziness.      

What is the balance system?  

The human balance system is made up of four parts. The brain acts as a central computer receiving information in the form of nerve impulses (messages) from its three input terminals: the eyes, the inner ear, and the muscles and joints of the body which is our ability to sense vibration, pressure and position of the feet, ankles and knees.   There is a constant stream of impulses arriving at the brain from these input terminals.   All three systems work independently and yet work together to keep the body in balance.

The vestibular system (inner ear input) is the part of your balance system that provides your brain with information about the movements of the head and the head and body together.  The vestibular system informs the brain about movement of the head and body.  When the inner ears of balance are not working properly you might feel like you are moving when you are not moving at all.  Because your hearing and balance functions of your inner ear are so closely related, we routinely administer a hearing evaluation before balance testing to properly assess your entire balance system. 

Diagnosing the underlying cause of dizziness is a complex problem often requiring several tests that are collectively referred to as a balance function assessment.  

What is the VNG evaluation?    

Videonystagmography (VNG) is a valuable tool that is comprised of a series of tests used to determine the cause of your dizziness or balance related problem. Dizziness may be caused by any disturbance in the inner ear, the balance nerve or its central connections. This can be due to a disturbance in circulation, fluid pressure or metabolism, infections, neuritis, drugs, injury, or growths.   The VNG test is a simple and painless test used to determine whether or not the dizziness may be due to inner ear disease.  

VNG is a complete diagnostic system for recording and analyzing involuntary eye movements using video imaging technology.  Hi-tech video goggles with infrared cameras are worn during the testing to record your eye movements as you look at different targets, follow moving targets and move your head in different positions.  The final portion of the VNG involves putting warm and cool air into the ear canals to determine if the balance system is responding in a predictable manner.  

What is Rotary Chair Testing?   

Rotary Chair testing is the gold standard for the diagnosis of bilateral (both) vestibular loss.  It also tells us whether or not the brain has compensated for a loss of inner ear function on one side.  It is used with VNG testing to increase accuracy.  During the test, eye movements are recorded with the same video goggles with infrared cameras worn during the VNG test while the chair moves slowly.  

Preparing for your Balance Assessment

Because of the nature of the tests, there are some preparations you will need to make before your evaluation. Our staff will provide you with clear instructions on how to prepare for your examination. For example, we will ask you to discontinue certain medications, not to consume any alcoholic beverages or caffeinated drinks at least 48 hours before the tests, to remove contact lenses or eyeglasses and to fast for a few hours prior to testing. The exact instructions may vary from patient to patient. If you have any questions about your instructions or how to prepare for the test, ask your hearing health professional.

The entire Balance Assessment typically lasts about 90-120 minutes and can cause some dizziness. This dizziness usually subsides within a short period of time. It is advised that you bring someone with you who can drive you home afterward if you are unable to drive or do not feel well after the tests.