Some assessments can be quick and painless, while others are time-consuming and uncomfortable. Your physician can tell you what tests are appropriate for your situation.
Common Tests Used to Make the Vertigo Diagnosis
After asking about your symptoms, documenting your health history, and performing a general physical exam, your doctor might suggest one or more of the following tests:
Dix-Hallpike Maneuver
The Dix-Hallpike maneuver is commonly used if your doctor suspects you have benign paroxysmal positional vertigo (BPPV) — the most common cause of vertigo. This method can also help your physician figure out if your vertigo is due to an inner ear problem or something in your head. Your healthcare provider will turn your head 45 degrees to one side. Then, you’ll quickly lie on your back, with your head off the side of the table, and maintain the 45-degree head turn for at least 30 seconds. Your doctor will inspect your eyes and ask if you feel dizzy. The procedure is then repeated on the other side. You should know that this test could trigger unpleasant bouts of vertigo. If you develop symptoms during this test, your doctor will determine that you do indeed have vertigo. (1)
Head Impulse Test
The head impulse test evaluates how well your eyes and inner ears work together. It’s often used if a condition called vestibular neuritis is suspected. Your doctor will quickly rotate your head to look for certain rapid eye movements and reflex functions that could imply a problem in the semicircular canals of the inner ear. (2)
Romberg Test
For the Romberg test, you’ll be asked to stand with your feet together. Then, you’ll close your eyes. Your doctor will assess how much you sway or fall to determine what’s causing your vertigo. (1)
Fukuda-Unterberger Test
The Fukuda-Unterberger test requires you to march with your eyes closed. Your physician will look at how your body strays from the midline to identify which side of your body is affected by vertigo. (1)
Electronystagmography (ENG) or Videonystagmography (VNG)
ENG and VNG are used to detect abnormal eye movements and determine if vertigo symptoms are caused by an inner ear problem. ENG uses electrodes and VNG uses small cameras to measure eye movements while your head is placed in different positions or as you’re asked to track certain visual targets. Air or water may also be used to control your ear canal temperature. These tests are usually performed in a dark room and may elicit jerking eye movements. (3)
Rotation Tests
Rotation tests are used to see how well the eyes and inner ear work together. They involve moving the head slowly from side to side while analyzing eye movements. There are different types of rotation tests. You may be asked to sit in a chair that moves from side to side, or to look at a fixed target and move your head back and forth or up and down. (3)
Other Tests You May Get to Diagnose the Cause of Vertigo
Other tests used to diagnose vertigo may include:
Posturography Posturography analyzes your balance and posture. You’ll stand on a platform with your bare feet and try to hold your balance under different conditions.Vestibular Evoked Myogenic Potential (VEMP) This method evaluates whether your nerves and other parts of your body that are associated with the inner ear or balance are working properly. Sounds are played through earphones and special electrodes pick up and record the results.Hearing Tests These tests, also known as audiometric tests, measure your hearing function and can detect issues in the inner ear. They can also help your physician figure out if there’s a problem with the nerve that connects the inner ear to the brain. (4). There are several different types of hearing tests available. One test, called electrocochleography, helps determine if fluid buildup is causing excessive pressure in your inner ear. (4)Magnetic Resonance Imaging (MRI) An MRI scan may be used to help your doctor identify possible causes for your vertigo symptoms and rule out others. It uses a magnetic field and radio waves to create images of the inside of your body. This test is often used in people with hearing loss or neurological symptoms to pinpoint a cause. An MRI may show fluid buildup, inflammation in the inner ear, or a growth on the nerve. (4)Computerized Tomography (CT) Scan A CT scan is often used to let doctors see abnormalities, such as fractures or thinning bone, around the inner ear.Vision Tests Sometimes vision tests are recommended to help doctors find a cause for vertigo symptoms.Blood Work A blood test can reveal problems that could be to blame for your dizziness complaints. Your doctor might check your blood cell count, thyroid function, blood sugar levels, electrolytes, and more.Allergy Tests Sometimes allergies are the culprit for vertigo symptoms. Identifying what you’re allergic to may help doctors figure out what’s triggering your attacks.
If your doctor suspects other issues are causing your vertigo symptoms, you might be given different tests.
What Kind of Specialist Performs the Tests?
Your primary care physician, neurologist, or an ear, nose, and throat (ENT) specialist can perform some assessments to diagnose your vertigo. But you may be referred to an audiologist, physical therapist, radiologist, or other expert for more specialized testing. (3)
How Many Tests Will I Need to Get for a Diagnosis?
The testing you’ll need will depend on what your doctor thinks is causing your vertigo symptoms. It’s important to tell your physician about all of your signs and symptoms, so you both can come up with a strategy to diagnose and treat the underlying condition that’s triggering your vertigo episodes. Even after extensive testing, a cause for vertigo isn’t always identified. (4) Try to remain optimistic, even if this happens. There are several effective treatment options that can help your symptoms.
