Audiological and Vestibular Testing

Most patients with dizziness that we see have an audiogram and OAE (hearing tests) and a VEMP test. Depending on the situation, we may also reccomend additional procedures as below:

We offer the following tests for dizziness in the clinic:

• Hearing testing (audiometry), as well as tympanometry and acoustic reflexes
• Computerized Dynamic Posturography (Equitest)
• OAE testing
• ENG testing (electronystamography)
• Oculomotor testing (a subset of ENG testing, concerning eye movements alone). Oculomotor testing might be appropriate for a person with congenital nystagmus.
• Brainstem audio evoked responses (for central dizziness conditions and to screen for Acoustic Neuroma). We also do MLR testing (for central hearing loss).
• VEMP testing (Vestibular evoked myogenic potentials).
• ECOG (electrocochleography testing for Meniere's disease)
• Tilt-table testing (for fainting spells)
• Rotatory Chair testing.

Most other tests are obtained in Northwestern Memorial Hospital, which is across the street from the practice. In most instances, other than blood testing, these tests need to be arranged for several weeks in advance. Generally these tests are not routinely scheduled prior to the first visit but may be recommended after the evaluation.

• Neuroradiology --
  • MRI/MRA of the head or neck (for a large number of structural disorders of the brain or it's blood supply). Most MRI scans are done at the local hospital (Northwestern Memorial Hospital).
  • 3T MRI (higher field)-- These are very high resolution MRI scans, mainly suitable for cases where regular MRI imaging has been insufficient. These are done at 3T Imaging of Morton Grove (a suburb of Chicago).
  • CT scan of the temporal bone (for SCD or congenital deafness). Done at 3T MRI of Morton Grove. We strongly urge against having temporal-bone CT scans done at local hospitals. Even academic hospitals often do a poor job with temporal bone CT scans.
• Blood testing. Done on the second floor of Northwestern Memorial Hospital

Ear Wax removal

Practically, ear wax removal is sometimes needed to properly examine the ear, for hygiene, and to do proper testing. We use a Welch Allyn commercial ear wax removal system for most situations, and we use tympanometry for safety. Wax is also sometimes removed using the microscope by Dr. Hain.

Appointments can be scheduled solely for ear wax removal through our front desk, reception@dizziness-and-balance.com. We recommend a periodic schedule -- often every 6 months is appropriate.

Neuropsychological Testing

We occasionally suggest or arrange for neuropsychological testing (questionnaires), for three patient groups:

1. Workmans compensation cases
2. Independent medical examinations -- these are done at the request of the attorney who arranged for the IME
3. Persons with trouble thinking associated with dizziness.

The most comprehensive neuropsychological assessment that we offer is the MMPI. This is can be done in the clinic, under the supervision of Robert Hanlon, Ph.D.

The testing is typically prior to clinical examination, although results are not available for about a week.