What Is the Unterberger Test?

The Unterberger test is an evaluation of a patient with dizziness to determine if lesions on the cerebellum or inside the ear are responsible for patient’s symptoms. Patients are asked to walk in place for 30 seconds while care providers watch for signs of imbalance. It is one among a series of tests that can be performed in an office environment to collect information about the specific nature of a patient’s condition. Hearing and balance specialists may use this test, as may general practitioners who want some information about a patient to decide how to proceed with treatment. If there is an issue with the patient’s vestibular system, used to coordinate balance, the patient might need a referral to a specialist.
In this test, the patient’s eyes should be closed or covered, and the room must be quiet. The goal is to remove any stimuli that a patient could use for orientation. A space is cleared in the middle of the room to allow the patient to high step in place for the Unterberger test. Care providers stand close to the patient to intervene if there is a risk of an injury. If a patient’s vestibular system is in working order, it should be possible to stay more or less in the same position.
Patients with lesions in their brains or damage to the labyrinth of the ear can start to rotate or twist. They tend to move in the direction of the damage. Care providers can note how much rotation occurs and which direction the patient moves in. They may ask to repeat the test to confirm the findings. Other tests can provide more information about which tasks people can complete, and the severity of balance and orientation problems.
This is also known as the Fukuda test. Care providers can use it in a routine evaluation of a patient who reports dizziness or disorientation if a problem with the vestibular system is suspected. If the findings of the Unterberger test indicate that the patient does have a lesion, additional testing is often required, including scans of the brain. Testing can also be used to follow up on a patient with ongoing symptoms, or to monitor response to treatment.
Care providers do not use this as a definitive test. Patients may experience balance problems while performing the Unterberger test for a number of reasons, and more information is needed to put together a complete picture. Patients might be dizzy because of low blood pressure or blood sugar, for example, and could stagger during the Unterberger test because their legs feel weak.

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