While most balance disorders are caused by inner ear abnormalities, many balance disorders are caused by central nervous system abnormalities, cardiovascular problems or both. There are specific observational tests that can help your doctor figure out what is causing your balance problems.
Assessment of Eye and Head Movement Functions: The ability to coordinate movements of your eyes and head is essential to seeing objects in your environment clearly while you are in motion during such tasks as walking, running, or driving a car. To test your eye movement control, you may be asked to shift your direction of gaze from one object to another as quickly as you can. You may also be asked to look as far as you can to the left, right, up, and down while facing directly forward. To test eye and head coordination, your physician may observe how accurately you can stay focused on an object while shaking your head.
Assessment of Cerebellar Function: This includes specific physical examinations to evaluate your cerebellum, the part of your brain that is essential to your ability to control balance and movements. When your cerebellum has been damaged you can still move, but your movements become jerky, making it harder to get your hands or legs to stop moving just where and when you want them to. Your doctor can test how well your cerebellum is working by asking you to reach out and touch points with your index fingertip, tap your hand rhythmically, and move your arms and legs accurately.
Assessment of Walking Function: Your doctor can learn about your balance and movement control by observing how well you walk. He or she may ask you to walk in a straight line without veering from side to side and then quickly and accurately turn and walk in the opposite direction without hesitating or stumbling. A more challenging walking task is called “heel to toe” walking, where each new step is placed directly in front the preceding step.