Testing vestibular system: Bedside tests and Lab tests.
Office Tests of Vestibulo-Spinal Reflex and Postural Control function
Musculoskeletal Assessment Ankle, Knee, and Hip Joint Range-of-Motion, Ankle, Knee, and Hip Joint Strength, Sensation in the Distal lower limbs, Deep-Tendon Reflexes
Tandem (Sharpened) Romberg.
Modified Clinical Test • for Sensory Interaction of Balance
Fukuda Stepping Test
Casual Gait-With and Without Reciprocal Horizontal Head Movements.
In Summary Test Battery available for Hearing and Balance disorders:
Hearing test: Acts as a baseline for other tests and can also be abnormal in MD.
ABR: Useful in detecting retrocochlear pathology.
Ecoch.G: Diagnostic test in MD and Endolymphatic Hydrops.
cVEMP: The only tests for Inf Vestibular nerve function and Saccule.
oVEMP: The only test to assess the utricular function.
vHIT: Can test all the SSC a new and promising test to find out high frequency Vestibular disorders.
VAT: Another test to sind out high frequency vestibular disorders.
VNG/ENG: Considered almost a gold standard in vestibular testing. But has deficiencies as it can only test Lateral Canal through Caloric test. Occulomotor tests help us diagnose any central vestibular pathologies. Also helps diagnose BPPV.
Rotatory chair: Tests mid frequencies and also a gold standard for bilateral lesions.
CDP: Helps diagnose functional effects of vestibular disorders. Also helps find malingerers.
No Single test can assess the entire sense organs of vestibular system so most physicians use a selection of tests based on individual history, examination and clinical presentation of the patient.