The Neurological Examination:
A complete neurological examination is always the starting point for diagnosing balance disorders. A highly trained neurologist typically performs the examination, though other medical professionals specifically trained to evaluate patients with brain disorders may also be involved. The neurological examination is mostly science, but partly art and neurologists have been performing their examinations in pretty much the same way for more than 100 years. During the neurological examination, the patient may be asked to perform certain tasks that evaluate a specific part of the brain or spinal cord. Also, reflexes and strength are tested in different ways. In patients with balance disorders, observing the patients "gait," or manner of walking is often most important. After this initial examination, the neurologist typically has a certain diagnosis in mind and further diagnostic testing can be ordered (for example, an MRI of the brain) to confirm the suspected diagnosis.

Computerized Dynamic Posturography (CDP):
Normal balance requires the integration of proprioceptive (sensation from the feet), visual, and vestibular (inner ear) inputs. During posturography, the patient stands on a computerized platform while balance is measured under different circumstances that stress each of the three input systems. For example the floor may move beneath the patient's feet, or the visual surroundings may tilt in a certain directions. The reflex movements made by the patient to keep from falling are measured and this helps determine which part of the balance system is affected by disease.

Voltage-actuated Nerve Conduction Thresholds (V-sNCT):
V-sNCT is a quantitative method of determining sensation of the feet. If sensation is impaired by nerve abnormalities (neuropathy), the floor cannot be felt well beneath the feet and this will lead to imbalance, particularly when vision is impaired or when the patient is attempting to maintain balance in darkness. At out center V-sNCT is performed by a computerized system that measurers nerve ending responses to electrical stimulation.

Oculomotor Testing:
During oculomotor testing, infrared video cameras are used to record eye movements with very high precision. Typically, the oculomotor evaluation involves several sub-tests: saccades, smooth pursuit tracking, gaze-evoked nystagmus, and optokinetic nystagmus. During each of the tests, the patient watches lights projected on a screen while the eye movements are recorded and analyzed by a computer. Certain abnormalities of eye movements then can be used to diagnose abnormalities in specific brain regions.

Magnetic Resonance Imaging (MRI):
MRI is a method of capturing high-resolution pictures of the brain. During an MRI, the patients lay in a large tube while magnetic fields are used to capture information about the brain. A powerful computer translates the information into images that are so detailed that the modern MRI has been compared to direct viewing of the brain (like that seen during autopsy). MRI can be crucial in diagnosing disorders of the brain (such as stroke) that can lead to imbalance.