Schedule Appointment

At one of our
5 locations in the
Washington, DC
Metro Area

Ask a Question or
Suggest a Topic

For a Future Episode

Podcast Form

Are You Feeling Dizzy?

A neurodiagnostic evaluation is a comprehensive look at every aspect of the ear, brain, and balance system to help people with their equilibrium.


Are you feeling dizzy? Neurodiagnostic testing could be right for you. That’s our topic today on Ask the Hearing Doctors


Hi, I’m Dr. Jenna Valania, one of the audiologists at Hearing Doctors, the Washington D.C. metro areas highest rated audiology practice with over 1500, 5-star reviews. Today, I’m joined by Dr. Richard Gans, the founder of the American Institute of Balance. Dr. Gans, it’s great to have you today.


Thank you. Dr. Valania, nice to be with you.


We are so excited about our partnership and all of our patients are wondering what exactly is neurodiagnostic testing?


Good news for the patients. Simple, easy. No pins, needles. Under less than 70 minutes. We’re going to have a comprehensive look at every aspect of the ear, the brain, the balance system that is going to help people with their equilibrium. We even can do this testing on infants as young as three and four months of age. So, it’s all very simple and nothing to be concerned about.


That is awesome to hear. Our patients will be very happy to hear that.


And covered by insurance.


They will love that even more. We have a lot of patients that come to us and they’re like, I’ve been told that I need to get balance testing now. Some of them are able to read on the internet and they hear something called a VNG, but we know that neurodiagnostic testing is so much more than that. Can you give us some details?


Absolutely. The VNG test is actually well over 70 years old, and some of it was related to merely putting warm or cool air or water in someone’s ear and then measuring their eye movement. Very primitive test. And while it still exists, it would be like saying, well, the cardiologist is still going to use a stethoscope, but we’re way beyond that.


So, today’s testing, modern, comprehensive testing is able to look at all of the different structures within the balance mechanism of the ear, the brain and your postural stability. So, we want to look at all aspects, the old VNG test, while we still have kind of harvested some of these tests really didn’t give us that full picture. So many people could have a completely normal test. They’re dizzy, they’re miserable. But it was read as being normal because it only looked at a tiny part of what was really going on. So today, virtually 99% of patients who go through the evaluation process, we are going to find a solution for them in less than 70 minutes.


That is so comforting to hear both as a provider and someone that really does care for my patients in the regard that I don’t want them doing testing that one, they’re going to be uncomfortable, and two that they just feel that we are just another provider that’s looking at their dizzy problems. Tell me some reasons why people should get neurodiagnostic testing.


Well, many people also have other medical conditions. So, for example, if you have high blood pressure or you’re diabetic, well, what happens sometimes is if you complain about a symptom, everyone wants to blame it on the diabetes or maybe your blood sugar was low or, you know, did you take your blood pressure medication? Have you been monitoring your salt intake, all these other things. And that’s where the problem is, because most folks, by the time they get to their fifties or beyond, have other kind of medical conditions and to just blame everything on the fact that you have elevated cholesterol or your blood pressure is a little high, is dangerous because it negates the fact that you also have inner ear. You have a brain. And if you’re dizzy and that dizziness, for example, is caused by change in your head position, oh, I’m fine if I’m sitting up, but I’m not fine if I’m laying flat. Oh, that’s your blood pressure. No, it’s just the opposite. Your blood pressure would probably make you dizzy if you were sitting up, not laying down.


So, we have to make sure that physicians and patients alike understand that they don’t just have to learn to live with it.


And that is, I would say, one of the biggest concerns that people come to us is when we ask them, okay, tell us a little bit about your balance system or your neurodiagnostic system that we could do for our testing. And a lot of them and say, I get really dizzy when my position changes. Is there a specific word for that?


Well, positional vertigo can be caused by a number of things, but the number one cause is Benign Paroxysmal Positional Vertigo. So benign means it’s not cancer, it’s not a tumor. Paroxysmal is a big word, but it just means fast onset. Positional, of course, is the body position. And vertigo, we know, is when you have the hallucination that the room is spinning. Obviously, the room isn’t spinning.


But to the person who has it, you absolutely feel that’s happening. This is the number one condition that causes vertigo laying flat, looking up. Sometimes it’s been called top shelf vertigo because it occurs when you’re outside and you’re putting up your Christmas decorations or you’re bending over to refill your doggy dish or whatever. Now, the good news is that this condition is very common.


It has to do with some debris from the inner ear that is pure beach sand. It’s called calcium carbonate. All right. And it can accumulate to the point where your body just can’t absorb the amount. Usually, it’s linked to a vitamin D deficiency. So, we very often tell patients, make sure you’re getting your vitamin D levels checked. Right. And be treated appropriately. The good news is that we’ve now treated over 15,000 patients with this, usually in less than two visits, patients are 100% perfect and ready to go. It can also happen in young children or young people after even a mild head bump. So, a child falls off a skateboard. You bend over to pick up a pencil that rolled under your desk and you whack your head on the way up, and then a day or two later you feel dizzy.


It’s because you’ve dislodged a few more crystals than your body is able to absorb. We use what’s called a canalith repositioning maneuver This is the gold standard. If you went to Hopkins Mayo, Cleveland Clinic, one of the big universities, this is what we do. So, it’s a quick two or three minute treatment. We don’t recommend people doing it at home. Don’t go to YouTube. You’ll end up in the emergency room. Go to Hearing Doctors. Right. It should only be done in the hands of specialized practitioners such as yourself.


Absolutely. I completely agree. Thank you so much. For providing that information for us. We’re very excited to be able to share this with our patients. If you’re looking for more info or want to know more about Dr. Gans and the American Institute of Balance, please visit to continue to watch our podcast series. Thank you so much.


If you’re in the Washington metropolitan area and you’d like to schedule an appointment with Hearing Doctors, click the link in the description or visit

Do you know somebody that needs to see this? Why not share it?

Dr. Ana Anzola, CCC-A, FAAA, ABA Principal

Dr. Anzola received her Doctorate degree in Audiology (AuD) from the Arizona School of Health Sciences, and her Master’s Degree in Audiology and her Bachelor's Degree in Speech Language Pathology and Audiology from Towson University. She has been a fellow of the American Academy of Audiology (AAA) since 1995, board-certified by the American Board of Audiology (ABA), and certified by the American Speech-Language-Hearing Association (ASHA).


McLean, VA...........(703) 962-6139
Cascades, VA.....(703) 722-8222
Falls Church, VA...(703) 485-4531
Fairfax, VA............(571) 295-5613
Rockville, MD........(301) 761-2988
Falcons Landing....(703) 722-8175
Silver Spring..........(301) 761-4758
Toll Free.................(703) 822-7328

See addresses & office hours >>