Services

Services offered at Topple Diagnostics  

At Topple Diagnostics, we strive to provide accurate and detailed patient evaluations so our clinical staff can provide the most comprehensive diagnosis and recommendations for your patients. Below, we have compiled a list of our available services as well as short videos to provide information about the different aspects of our test battery and how our diagnostic process offers comprehensive evaluation for your patients.

Medical treatment

ACTIVE HEAD ROTATION

Measures the vestibulo-ocular reflex and current labrynthine function.

AUDITORY BRAINSTEM RESPONSE

The ABR test is performed to assess neural synchrony from the distal end of the VIIIth nerve through the low brainstem.

CALORIC IRRIGATION

Assesses horizontal semicircular canal function independently. It is considered gold standard for diagnosis of peripheral hypofunction.

MODIFIED CLINICAL TEST OF SENSORY INTERACTION ON BALANCE

Measures how an individual performs when one or more sensory systems involved in maintained equilibrium is compromised.

OTOACOUSTIC EMISSIONS

Measures the mobility of the outer hair cells in the cochlea along a broad frequency spectrum.

PURE TONE AUDIO CONNECTION

Assesses the cochlea and can help determine the degree of hearing loss and if any asymmetry is present.

TYMPANOMETRY & IPSILATERAL REFLEXES

Tympanometry is a measure of mobility of the ear drum and the bones and ligaments in the middle ear cavity. Ipsilateral Reflexes measure how loud a sound needs to be to trigger the mechanism that briefly paralyzes the middle ear bone movements to protect the inner ear.

VERTEBRAL ARTERY SCREENING TEST

Assesses the vertebro-basilar arteries when in provoking positions.

CERVICAL VESTIBULAR EVOKED MYOGENIC POTENTIALS

VEMP measures the vestibulo-spinal reflex (VSR). It is the only test available to evaluate function of saccule (inner ear organ) and inferior portion of VIIIth nerve.

OCULAR VESTIBULAR EVOKED
MYOGENIC POTENTIALS

Ocular VEMP measures the Vestibulo-Ocular Reflex (VOR). It is the only evoked potential test to evaluate the utricle (inner ear organ), superior portion of the VIIIth nerve, and the projections to the extra-ocular muscles.

VIDEONYSTAGMOGRAPHY:
OCULAR MOTILITY & GAZE TEST

Part of videonystagmography, saccades, smooth pursuit, and optokinetic tracking are tests assessing eye movement and ability to stay on a target. Gaze Test (vision denied) assesses eye movement in four directions (center, left, right, up) while patient is in total darkness.

ELECTROCOCHLEOGRAPHY

Electrophysiologic test looking to establish AP, SP, and baseline amplitudes that helps clinicians determine the pressure of the endolymph in the cochlea.

VIDEONYSTAGMOGRAPHY:
DIX-HALLPIKE & POSITIONAL TESTING

The Dix-HallPike Test assesses for benign paroxysmal positional vertigo (BPPV). Positional testing checks for horizontal canal benign paroxysmal positional vertigo (BPPV), peripheral labyrinthine dysfunction, or central involvement.