Role of posturography in the management of vestibular patients

Computerized dynamic posturography uses a force platform that can both translate and rotate. When combined with visual stimuli, it can be used to determine the relative importance of the various sensory inputs critical for balance, namely vision, somatosensation, and vestibular sensation. Studies to date have shown several patterns of abnormalities on posturography, the best recognized being the vestibular pattern. Many patients with a high suspicion of having a peripheral vestibular abnormality (based on other information) have such a pattern. Moreover, few normal subjects have such abnormalities. Although computerized dynamic posturography does not help in localizing a lesion or determining its etiology, such testing does provide a functional measure that can be helpful in understanding a patient's ability to properly use vestibular system information. Posturography is helpful in the management of patients with suspected vestibular disorders. In addition to suggesting the presence of a vestibular system abnormality, particularly an uncompensated peripheral vestibular deficit, a bilateral peripheral vestibular deficit, or a central vestibular abnormality, computerized dynamic posturography may help guide the clinician regarding choice of treatment and counseling of patients. Further studies are required to determine the ultimate role of computerized dynamic posturography in the management of patients with vestibular disorders.