Lifeline Audiology & Hearing Solutions

Balance Testing

Balance testing is designed to objectively evaluate an individual’s postural stability and vestibular function.

Is It Time to Get a Balance Test?

If you’ve experienced dizziness, frequent falls, or trouble with coordination, a balance test can be a valuable tool. It helps pinpoint the cause of these issues, which could range from inner ear problems to neurological conditions. Early diagnosis allows for targeted treatment to improve your balance, reduce falls risk, and enhance your overall safety and well-being.

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Balance Consultation

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Are you chronically dizzy or do you experience sensations of unsteadiness?


Do you have difficulty walking or turning?


Do you experience frequent falls?


Do you experience frequent nausea or vomiting?


Do you notice visual disturbances?

Balance and the Vestibular System

The medical term for the part of the inner ear involved with balance is called the vestibular system. The vestibular system is an organ located within the inner ear which relays information to the brain about balance and orientation of the head and body.  Balance is a complex interaction which requires input from our vestibular system, in addition to our vision and the sensation from our feet, muscles, and joints. If any one of these systems are not working properly, you will suffer loss of balance.

What Can Cause a Balance Disorder?

A balance disorder may be caused by viral or bacterial infections in the ear, a head injury, or blood circulation disorders that affect the inner ear or brain. Many people experience problems with their sense of balance as they get older. Balance problems and dizziness also can result from taking certain medications. However, many balance disorders can begin all of a sudden and with no obvious cause. Your physician may have referred you to our clinic as the balance experts who will help in the process of determining possible causes and best treatment options. Balance disorders fall into two main categories.

Dizziness, vertigo or motion intolerance

This condition may be caused or worsened by rapid head movement, turning too quickly, walking, or riding in a car.  These symptoms can be acute or sharp attacks lasting for seconds or sometimes for several hours.

Persistent sense of imbalance or unsteadiness

Some people refer to this as a loss of surefootedness.  There can be many causes of dizziness and imbalance, with the largest percentage coming from the vestibular system.

Did You Know?

  • According the National Institute of Health (NIH), dizziness or loss of balance will affect 90 million Americans sometime during their lifetime.
  • Dizziness is the number one complaint reported to medical providers in adults 70 years of age or older.
  • Balance-related falls account for more than one-half of accidental deaths in the elderly.
  • Balance-related falls cause over 300,000 hip fractures in individuals over 65 years of age
  • Children can also be affected by inner ear disorders and are sometimes incorrectly diagnosed as learning disabled, dyslexic, or psychologically disturbed.
  • Inner ear disorders or ear infections can result imbalance and vertigo affecting a person’s ability to walk, roll over in bed, see or think clearly, or to read or watch television.
  • Many times, disorders of the inner ear are misdiagnosed as a more severe neurological condition such as multiple sclerosis, or as clinical depression.
  • Inner ear disturbances account for 85% of dizzy disorders.
  • Illness, infections, disease, head injuries and whiplash are frequent causes of imbalance, dizziness, and vertigo.

The Dizzy Test Battery

A neurodiagnostic/vestibular test battery, is a series of tests designed to evaluate your balance system. Since the inner ear controls both hearing and balance, you may be referred for tests for either hearing or balance, or both. The tests themselves are painless and use the latest technology.

Auditory Brainstem Response Test

An Auditory Brainstem Response (ABR) test, also known as Brainstem Auditory Evoked Response (BAER) test, is a diagnostic procedure used to assess the function of the auditory pathway from the ear to the brainstem. It is typically performed to evaluate hearing sensitivity and diagnose hearing disorders, particularly in infants, young children, or individuals who cannot participate in traditional behavioral hearing tests.

During the ABR test, small electrodes are placed on the scalp, forehead, and earlobes to detect electrical activity generated by the auditory nerve and brainstem in response to sound stimuli. The patient is usually positioned in a quiet room or sleep state to minimize interference.

A series of clicks or tones of varying intensity are presented through earphones or speakers, and the electrodes measure the brain’s electrical responses to these stimuli. The test records the time it takes for the auditory signals to travel from the ear to the brainstem, as well as the strength and consistency of these responses.

The recorded responses are analyzed by a trained audiologist or healthcare professional to determine the presence, degree, and nature of any hearing impairment or neurological abnormalities. A normal ABR waveform indicates typical hearing function, while abnormalities in the waveform may suggest hearing loss, auditory nerve disorders, or other neurological conditions affecting the auditory pathway.

The ABR test is particularly useful for diagnosing hearing loss in newborns, infants, and individuals with developmental disabilities who may have difficulty responding to traditional behavioral hearing tests. It can also help differentiate between sensorineural (inner ear) and conductive (middle ear) hearing loss and assess auditory nerve function in cases of suspected auditory neuropathy or retrocochlear pathology.

Overall, the ABR test is a valuable tool in the diagnosis and management of hearing disorders, providing valuable information about the integrity of the auditory system and guiding appropriate intervention and treatment strategies to optimize hearing health.


A Videonystagmography (VNG) is a diagnostic test used to evaluate the function of the vestibular system, which includes the inner ear and parts of the brain responsible for balance and eye movements. It is commonly performed to assess patients with symptoms of dizziness, vertigo, imbalance, or other vestibular disorders.

During a VNG test, the patient wears specialized goggles equipped with infrared cameras that track eye movements. The test typically consists of several components:

1. **Spontaneous Nystagmus:** The patient sits quietly with their eyes open and closed while the technician observes for any involuntary eye movements called nystagmus.

2. **Positional Testing:** The patient’s head is moved into various positions to assess for positional nystagmus, which may indicate benign paroxysmal positional vertigo (BPPV) or other vestibular disorders.

3. **Caloric Testing:** Warm and cool air or water is gently introduced into each ear, one at a time, to stimulate the vestibular system and induce nystagmus. This helps evaluate the function of the inner ear and vestibular nerve on each side.

4. **Optokinetic Testing:** The patient watches moving visual stimuli, such as rotating patterns or moving lights, to assess their ability to visually track objects and detect abnormal eye movements.

5. **Saccade Testing:** The patient performs rapid eye movements (saccades) to assess the integrity of neural pathways involved in controlling eye movements.

The VNG test records and analyzes eye movements and nystagmus patterns, providing valuable information about the function of the vestibular system and helping clinicians diagnose and differentiate between various vestibular disorders. The results are interpreted by a trained audiologist or healthcare professional to determine the presence, severity, and nature of any vestibular abnormalities and guide appropriate treatment and management strategies.

Overall, VNG testing is a valuable tool in the evaluation of vestibular function, providing valuable insights into the health and function of the inner ear and vestibular system and helping clinicians diagnose and manage a wide range of vestibular disorders.

Therapies & Treatment Options

The Epley Maneuver and the Canalith Repositioning Maneuver (CRM) are both therapeutic techniques used to treat benign paroxysmal positional vertigo (BPPV)

The Epley and Canalith Repositioning Maneuvers*

If you have ever felt dizzy when tilting your head back you could have Benign Paroxysmal Positional Vertigo (BPPV), a common inner ear issue. The Canalith Repositioning Maneuver (CRM) and the Epley maneuver are treatment options for BPPV. Both CRM and Epley maneuvers are physical therapy techniques used to treat BPPV. Tiny calcium particles, called canaliths, can get lodged in the inner ear canals, sending confused balance signals to the brain and causing dizziness. These maneuvers aim to dislodge these particles, restoring balance.

Think of your inner ear canals like a playground for tiny pebbles (canaliths). In BPPV, these pebbles get stuck on the slide (a specific canal). CRM and Epley maneuvers are like gentle nudges, trying to get the pebbles off the slide and back to the sandbox (a different canal) where they belong. The key difference lies in the specific head and body positions used. The Epley maneuver, named after Dr. John Epley who developed it, is a widely used and well-studied CRM technique. It involves a precise sequence of head turns and body rolls while lying down. Other CRM techniques might have slightly different positioning, but the overall goal remains the same – to move the canaliths.

*These maneuvers should only be performed by a trained medical professional to ensure proper technique and avoid further injury.

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8553 Argyle Business Loop Ste D
Jacksonville, FL 32244

Fernandina Beach

1416 Park Ave Ste 201
Fernandina, FL 32034

North Jacksonville

2255 Dunn Avenue., Ste 103
Jacksonville, FL 32218

Phone & Fax Numbers

P:(904) 479-5198
F:(904) 417-7012