The first phase of balance testing is a physical exam. Watching you walk in a straight line and turn quickly and accurately will help your doctor assess your balance and movement control. Your head and eye movement will be assessed; this can be done by monitoring how fast you can switch your gaze from one object to another or trying to keep your gaze fixed on an object while shaking your head back and forth. To test how well your cerebellum (the part of your brain that controls balance and movement) is functioning, you may be asked to reach out and touch objects with your index finger or move your arms and legs in a specific way.
A hearing test may also be performed, as an issue with your hearing will indicate a problem with the inner ear. Measuring your eye movements lets your doctor know if you are having trouble seeing clearly while moving or if objects appear to be moving when they are not. Nystagmography is used to measure how well you can follow objects with your eyes. Your eye movements will be measured with electrodes (ENG) or infrared video (VNG). Posturography is used to measure how well you are able to maintain your balance while standing on a moveable platform and looking at a moving pattern. This enables the doctor to isolate specific sensory information to try to pinpoint the problem. Imaging such as CAT scans and MRI may be performed in order to make sure all the structures and nerves inside your head are normal.