Balance services

If you have dizziness or imbalance you will be firstly be seen by Nose and Throat (ENT) services for an assessment, who may then refer you to us for a specialist balance assessment.

Getting ready for your appointment

The following preparation is needed to ensure all tests can be carried out:

Do

have your ears checked for wax at the GP surgery. Your ears need to be completely free of wax.
If you have any heart problems, epilepsy, neck/back problems or are unable to maintain a lying down position please let us know before your appointment.

Do not

do not take any balance medication for 48 hours before your appointment
do not take alcohol 48 before your appointment
do not wear make up
It is advisable not to drive home after your appointment, so please make alternative arrangements.

What happens at your appointment

Your appointment will last up to 2 hours. We will discuss your medical history and any recent changes. We will look in your ears and carry out a test to check your middle ear function.

Different tests are then carried out to see how well the balance organ in the ear is working. These may include some or all of the following:

video head impulse test: this involves wearing some goggles and focusing on a target whilst the audiologist moves your head in different directions.
vestibular evoked myogenic potentials (VEMPS): this involves placing some sensors on your forehead and neck. We then ask you to move your head into a certain position and play you a sound through some earphones. We will then be measuring the activity in one of your neck muscles.
balance pad: this is a functional balance test that involves balancing on a stationary platform and staying as still as you can.
videonystagmography (VNG): this involves wearing goggles and looking at targets/moving into different positions on a couch.
air caloric: this involves lying on the couch with some goggles on. We then use some warm and cool air in the ears to stimulate the balance organ, this can make you feel a little dizzy but it will only last a minute or two.

What happens after your appointment

You may feel tired after the appointment so we advise getting some rest if possible.

We will send your results to ENT and they will arrange a follow up appointment to go through the results and decide on a management plan.

We may also refer you for some vestibular (balance) rehabilitation.

Benign Paroxysmal Positional Vertigo (BPPV): The sudden sensation that you are spinning or the inside of your head is spinning.

If you are diagnosed by ENT with BPPV or by us, then you may be referred to the audiology epley service, please see the ‘BPPV Information Leaflet’ for further information.