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Duke's balance disorders program is the Southeast's premiere clinic for diagnosing and treating balance problems and vestibular disorders. Our experts specialize in inner ear disorders that affect balance, including dizziness, migraine-associated vertigo, Ménière’s disease, benign paroxysmal positional vertigo (BPPV), vestibular neuritis and labyrinthitis, acoustic neuroma, perilymph fistula, intracranial hypertension, and mal de débarquement.
Comprehensive approach to balance problems
Whether you are experiencing debilitating dizziness, vertigo, unsteadiness, falls, or other chronic symptoms triggered by inner ear disorders, our vestibular disorders clinic offers the latest diagnostic techniques to discover what’s wrong, and uses innovative, personalized therapies to provide rapid symptomatic relief--without surgery.
- Expert care produces excellent outcomes. Our balance assessment and treatment team includes neurotologists who specialize in vestibular disorders (inner ear balance system), balance problems and all forms of dizziness, PhD- and AuD-level audiologists, trained in vestibular assessment, and PhD-level physical therapists who work only with patients needing vestibular rehabilitation.
- Benefit from our expertise. Our specialists focus their research on balance problems, including migraine-associated vertigo, Ménière’s disease, chronic, disabling disequilibrium, and viral inner ear diseases. We are conducting several ongoing studies that are providing insights aimed at improving therapies for these often disabling conditions.
- Access to tomorrow’s treatments. In addition to receiving the best available current therapies for a variety of vestibular disorders, eligible patients with targeted disorders can choose to participate in clinical trials for new treatments that may become tomorrow’s standard of care.
A special form of physical therapy with specific exercises designed to train your body and brain to make up for inner ear dysfunction, help you feel steadier on your feet, and relieve or reduce disabling symptoms. Includes:
- Consultation. Determines if vestibular rehabilitation therapy will help your dizziness or unsteadiness.
- Evaluation of current abilities. Includes finding out which positions or movements spark symptoms of dizziness or unsteadiness. Our vestibular rehabilitation therapists use this information to track your progress over time.
- Personalized rehabilitation program. Designed to improve your symptoms, restore function, prevent falls, and enhance quality of life.
Depending on your symptoms, treatment may include drugs to reduce nausea and motion sickness (anti-emetics) or vertigo and dizziness (vestibular suppressants, such as anticholinergics, antihistamines, and benzodiazepines). In some cases, steroids (such as prednisone) or antibiotics (such as amoxicillin) may also be prescribed.
To pinpoint the cause of your dizziness, Duke’s balance lab uses leading-edge diagnostic tests, including computerized technology that is only available at a handful of centers nationwide. This comprehensive assessment of the balance system gives precise information about how your brain is processing signals from your inner ear. The results provide an accurate diagnosis and also guide decisions about the best treatment for you. Audiologists with extensive training in balance problems conduct the balance function testing and analyze the findings.
Measures how well your eyes and inner ears work together. You will sit in a dark room watching various light patterns. At times, the chair rotates while you look straight ahead and chat with the audiologist.
Checks for damage to the ears' vestibular nerves. The audiologist makes recordings from the muscles in your neck and/or eyes while you lie back in an exam chair and listen to sound through headphones.
A group of tests that measures eye movements as you look at different light patterns, and checks for signs of balance system dysfunction. VNG/ENG testing includes the circulation of warm or cool water through your ear canal. During the exam, you’ll be asked a series of simple questions while the audiologist records eye movements stimulated by the temperature change.
The Video Head Impulse Test (vHIT) measures how the eyes move in response to rapid head movements. You wear a device on your head that measures eye movements as the audiologist moves your head. This test allows assessment of parts of the inner ear that previously were not accessible to objective measurement.