The Balance Center​

Overview

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The Balance Center at Cleveland Clinic Abu Dhabi helps patients suffering from dizziness and vertigo.

Dizziness is a general term that encompasses loss of balance, lightheadedness, a spinning sensation or an inability to walk straight, among other symptoms. It can be caused by problems in the inner ear, brain, eyes, or neck, and sometimes involves multiple causes. For patients affected by dizziness, receiving an accurate diagnosis that identifies the cause of the symptoms is vital to be able to return to their normal lives.

The multidisciplinary team at the Balance Center consists of experienced audiologists, otologists, and physical therapists, who are experts in the assessment and treatment of patients with a variety of diseases causing dizziness. The specialist team also works closely with caregivers from other specialties across Cleveland Clinic Abu Dhabi, including neurology, neurosurgery, cardiology, and spine surgery.

What We Treat

The Balance Center treats patients with the following conditions:

• Dizziness
• Vertigo
• Meniere’s disease
• BPPV (inner ear crystals)
• Labyrinthitis
• Neuronitis
• Vestibular migraine.

Diagnosis & Treatment

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An accurate diagnosis of the cause of dizziness is key to successful treatment, and to returning to a normal life quickly. When you visit the Balance Center, you will initially be assessed by our otologists, who will obtain a detailed history of your symptoms and conduct a thorough physical examination. Based on this, they will then order tests that assess the hearing and balance functions of the inner ear.

Balance tests

The most common tests to assess the inner ear function as well as the balance system in general include:

• Video-nystagmography (VNG): This test is an essential element in the diagnosis of dizziness. It allows evaluation of the vestibular function of the inner ear, provides insight into central (brain) components of dizziness, and allows lateralization of the lesion to one ear or the other.
• Computerized Dynamic Posturography (CDP): Allows separation of the different components of balance control, including contributions of the visual, vestibular, and somatosensory (muscle and joints) systems to balance. It is an extremely helpful test for patients with vague, possibly multi-causal dizziness and is an important part of establishing rehabilitative individual therapy protocols.
• Video Head Impulse Testing (vHIT): This is a test that evaluates the inner ear balance function by examining the semicircular canals.
• Vestibular Evoked Myogenic Potential (VEMP): This evaluates the inner ear balance function by examining the saccule and utricle. There are two types of VEMP test: Cervical VEMP (c-VEMP) or Ocular VEMP (o-VEMP).
• Electrocochleography (EchoG): A specific test that measures small electrical waves within the inner ear in response to sounds. It is easy to administer and can give good indications about the presence of Meniere’s disease.

In addition to Balance Tests, your doctor may request imaging tests, such as an MRI of the inner ear, brain, or spine. Following a thorough assessment and discussion by the whole team, a treatment plan will be offered to you. This may include a combination of medical treatment and vestibular rehabilitation therapy, a specialized form of physical therapy focused on improving your balance.

Vestibular Rehabilitation Therapy (VRT)

Vestibular rehabilitation therapy (VRT) is a specialized form of therapy provided by physical therapists that is intended to alleviate problems caused by inner ear disorders, primarily vertigo and dizziness, gaze instability, and imbalance. A comprehensive evaluation will be performed by our physical therapists to first assess the type of problems that vestibular disorder is causing. A follow-up session and customized exercise program will then be given which will focus on improving balance. Three types of exercises are prescribed usually prescribed:

• Habituation: This type of training involves repeating the movements that causes dizziness.
• Gaze Stabilization: This type of exercise improves eye control during head movements.
• Balance training: These exercises are used to improve steadiness during various daily activities that require standing and walking on uneven surfaces, and in the dark, without losing balance.

Meet Our Team

The Balance Center at Cleveland Clinic Abu Dhabi is a multidisciplinary collaboration of skilled caregivers from across several specialties, including:

• Audiologists
• Otologists
• Physical therapists.

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