Overview

The Balance Center at Phelps offers comprehensive diagnostic testing and individualized rehabilitation for people who are experiencing dizziness or imbalance or have been falling. The  staff of experienced physicians, audiologists, occupational therapists and physical therapists work as a team to diagnose the cause, improve the symptoms and help patients remain independent.

Phelps Balance Center

Please call for further information or to schedule an appointment.

What is dizziness or imbalance?

Dizziness is a word often used to describe feelings of lightheadedness, vertigo (a false sense of movement) or imbalance. Symptoms can last from a few seconds to several days.

Dizziness or imbalance can have a profound effect on one’s life. Activities of daily living may be curtailed.  Anxiety relating to the sudden appearance of symptoms may result in over-cautiousness about entering  social situations or going places where there is a risk of falling. Restriction of one’s activities may lead to inability to work, social isolation and general weakness.

Dizziness, imbalance or falls may be associated with the following:

  • Benign Paroxysmal Positional Vertigo (BPPV)
    • a disorder that causes brief, intense episodes of a spinning sensation with particular movements
  • Vestibular neuritis
    • infection or inflammation of the vestibular nerve that causes severe, continuing dizziness lasting hours to a few days
  • Labyrynthitis
    • infection or inflammation of the inner ear that causes severe, continuous dizziness lasting hours to a few days and hearing loss in one ear
  • Meniere’s Disease
    • thought to be related to an imbalance of inner ear fluids, characterized by episodes of vertigo, fluctuating hearing loss, roaring or buzzing in the ear and a sense of fullness in one ear
  • Stroke
  • Head injury
  • Motor vehicle accident
  • Aging
  • Migraine

Coordination of sensory information

The vestibular system (in the inner ear), the sensory system (feet, ankles, joints) and vision provide input to your brain needed to maintain proper balance. Dizziness occurs when the brain receives conflicting information from these three systems, or when the brain itself is impaired in its ability to interpret the information it receives.

Diagnostic testing

Audiological testing: The auditory and vestibular systems are directly connected. Therefore a hearing evaluation is a necessary part of the evaluation for dizziness.A hearing test measures your hearing sensitivity and clarity.

Vestibular testing is done to determine if an inner ear disorder is causing your dizziness or balance problem. It includes a battery of tests that use infrared cameras to measure the movements of your eyes, which are a reflection of inner ear vestibular function. The test often can determine whether a vestibular problem is in one or both ears.

Computerized Dynamic Posturography (CDP) evaluates the integration and coordination of sensory information from the eyes, the vestibular system and the legs, which are all involved in maintaining balance. Identification of the problem area(s) assists in developing an individualized rehabilitation program.

Imaging of the brain and temporal (ear) bone may be recommended in some cases following medical evaluation. The imaging modalities most often used in evaluation of a dizzy patient are MRI and CT scan.

Vestibular rehabilitation

If you are diagnosed with a vestibular disorder, a vestibular rehabilitation evaluation and therapy may be recommended.  This evaluation is conducted by a physical or occupational therapist with additional specialized training in vestibular and balance disorders.

After reviewing your symptoms and other pertinent medical history, the therapist will  analyze your strength, flexibility, coordination, gait, balance and posture.

The results of all of these examinations will indicate whether you are a candidate for further rehabilitation therapy.

Vestibular and balance therapies involve positioning maneuvers for reducing the symptoms of dizziness and imbalance. Therapy may also include exercises for coordinating eye and head movements, desensitizing the vestibular system,  and stabilizing the gaze to improve walking and balance.

Vestibular rehabilitation has been shown to be effective in managing dizziness and reducing balance problems, thereby lowering the risk of injuries due to falls. Most patients report that they have fewer symptoms and are able to return to activities that are important in their daily lives.

Balance Center staff

Medical evaluation is conducted by a physician with fellowship training in the evaluation and management of hearing and vestibular disorders. Primary care physicians, neurologists and cardiologists are also often involved in the medical evaluation of a dizzy patient.

Hearing and vestibular testing are conducted by audiologists who are licensed by New York State and certified by the American Speech-Language-Hearing Association (ASHA).

Vestibular rehabilitation evaluations and therapy are provided by New York State-licensed physical and occupational therapists, several of whom have received vestibular certification and other specialty training from Emory University in Atlanta, Georgia.

Phelps Balance Center team:

Cameron Budenz, MD

Medical Director
Neurotology, otology and skull base surgery

Puja Agarwal, PT, DPT, Physical Therapist

Manager, Physical Medicine & Rehabilitation
Vestibular Therapist certified by Emory University

Sheetal Shenoy, OTR/L, Occupational Therapist

Physical Medicine & Rehabilitation
Vestibular Therapist certified by Emory University

Jessica LaCorte, AuD, CCC-A, F-AAA, Audiologist

Coordinator, Audiology Services
Donald R. Reed Speech & Hearing Center

Swapna Nataraj, AuD, CCC-A

Audiologist
Donald R. Reed Speech & Hearing Center