Division of Otolaryngology
The Division of Otolaryngology offers personalized patient care, research programs and a variety of education and training opportunities.
Balance Disorders
Balance Disorders
Get Specialized Care for Dizziness and Balance Issues
When you experience dizziness and balance issues, everyday activities can be a challenge. Your risk of falling goes up, too, especially if you’re an older adult. Specialists in the Balance Center at Lahey Clinic diagnose balance disorders. We take the time to fully understand what causes your symptoms.
The Balance Center
Balance issues and problems with your inner ear often go together. At Lahey’s Balance Center, we help you address problems related to your peripheral or central vestibular systems.
Your peripheral vestibular system is a part of your inner ear that helps you keep your balance. It also helps keep your eyes focused while your head and body move. Your central vestibular system is located in your cerebellum. That’s the main balance center of your brain.
Symptoms of Vestibular Disorders
There are a variety of vestibular disorders. Symptoms of these disorders include:
- Imbalance issues (disequilibrium)
- Sensations that you’re moving through space even though you’re remaining still or that your surroundings are moving (vertigo)
- Spinning and motion sickness
When To Get Care for Balance Disorders
If you have problems with your balance, it’s important to speak with your primary care provider. These health issues become more common as people grow older. But there can be causes other than vestibular disorders. Your provider must rule out these other problems. If they do, they may recommend you seek care at the Balance Center.
Our Clinical Partners
The Balance Center is part of the Division of Otolaryngology. But vestibular specialists from several fields may be part of your care team. The balance center will work to connect you with appropriate specialists. These include:
More About Balance Disorders
Types of Balance Disorders
Central Balance Disorders
Central balance disorders originate in brain or brainstem, where balance signals are coordinated and processed. Common causes include:
- Neurodegenerative conditions
- Vestibular migraine
- Traumatic brain injury
- Stroke
Peripheral Vestibular Disorders
Peripheral balance disorders come from problems in the inner ear or vestibular nerve, which are responsible for sending balance signals to the brain. You may experience:
- Imbalance
- Vertigo
- Associated nausea
- Vomiting
Possible causes include:
- Benign tumor of the cranial nerve that comes from the brain and is essential for hearing and balance (acoustic neuroma) and certain other brain tumors.
- Inflammation of the inner ear (labyrinthitis).
- Inflammation of your auditory nerve (neuritis).
- Benign paroxysmal positional vertigo, a condition where tiny crystals (otoconia) in your inner ear move out of place
- Meniere's disease
Diagnostic Tests
Vestibular Function Testing
Depending on your symptoms, we may use one or more tests to help you get a diagnosis. These tests look at how your balance system (inner ear, eyes and brain) are working together. For these tests, you'll wear special goggles that record your eye movements. This is because your inner ear and eyes are connected through a reflex. This reflex keeps your vision steady while your head moves. By measuring eye movements, we can see how well this reflex is working and how your inner ear responds to different types of stimulation. This helps us identify possible causes of dizziness or balance problems.
Videonystagmography (VNG)
A VNG testing records your eye movements while we perform tasks that stimulate your inner ear and visual system. You'll wear special video goggles that allow us to track and measure your eye movements. The tasks may include:
- Introducing warm and cool air into your ear canal to stimulate your balance system. This may briefly cause a sensation of movement or dizziness.
- Following moving lights with your eyes.
- Changing the position of your head and body to see how you balance system responds.
Rotary Chair Test
Rotary chair testing is another way to evaluate how your balance system is working. For this test you'll sit in a darkened room in a chair that slowly rotates back and forth while we record your eye movements.
Electrophysiology Testing
Electrocochleography (ECochG)
A diagnostic test that measures how inner ear and hearing nerve respond to sound. During the test, an electrode is placed in your ear. Sounds are played through earphones, and the ear's electrical responses are recorded.
Cervical Vestibular Evoked Myogenic Potential (cVEMP)
Non-invasive test that checks how inner ear and balance system are working. During the test, you’ll wear earphones while small electrodes are placed on your neck. As sounds are played, you gently lift or turn your head, and the sensors record how your neck muscles respond.
Neurodiagnostic Auditory Brainstem Response (ABR)
A simple test that checks how sound travels from the ear to the brain. Electrodes are placed on your head, recording how your hearing nerve and brain respond to sounds. It helps identify possible problems along the hearing pathway.
