Balance testing: what is it all about?
Information for patients from Audiology
You have been referred to the hospital by your ENT (ear, nose, and throat) consultant or a GP with a special interest in ENT. The aim of the referral is to find out what is causing your balance problems. This leaflet will explain what tests you have been referred for, to find the cause of your symptoms.
We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please contact the Audiology Department.
What is the vestibular (balance) system?
Your vestibular (balance) system is in your inner ear. The vestibular organs contain a fluid called endolymph. When you move your head, this fluid begins to flow. The movement causes tiny hair cells to move and send messages to the brain about your movement.
Each ear has:
three semi-circular canals (also known as the vestibular system) which respond to rotational movement; and
two otolith organs, which respond to tilting movements.
Your vestibular system allows you to:
sense where you are in relation to the things around you; and
to perform the correct movements to steady yourself.
If there is a problem with your vestibular system, your ability to keep your posture and balance may be weakened. You will have to rely more on other cues, such as vision and proprioception (feeling in your muscles and joints).
What are the common symptoms of a balance disorder?
Dizziness or vertigo (spinning sensation).
Unsteadiness when walking.
Light headedness, fatigue (very tired), disorientation.
Visual disturbances, especially in busy visual environments, such as supermarkets.
What should I do before my appointment?
Please check with your GP that your ears are clear of wax.
Do not drink alcohol for 48 hours before testing.
Do not take any anti-dizziness / vertigo medication for 48 hours before testing. If this causes any problems, please contact your GP. You must continue to take all other medications, as instructed by your GP.
Bring your anti-dizziness medication to your appointment. You may wish to take some after your tests.
Please remove all eye make-up.
You may bring an adult to your appointment for support. Please do not bring young children.
What will happen at my appointment?
Please refer to your appointment letter for where to go when you arrive at the hospital.
Your clinician will go through your completed questionnaires and take a detailed medical history. This is so they can diagnose and find possible causes for your condition.
The vestibular tests may take up to 90 minutes to complete. Once you complete the tests you can go home.
We ask you to wear goggles and follow a moving red dot on a light bar with your eyes.
The goggles will track your eye movements whilst you are in different sitting and lying positions, both in dim light and in the dark.
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Patients wearing goggle, with the screen open -
Patients wearing goggle, with screen closed -
Patient sitting, wearing goggles
Testing may also include a procedure called caloric irrigation. During this test your clinician will stimulate your ear with warm and cool air in turn. This may cause feelings of movement and unsteadiness. It will not cause dizziness like you may have felt during an attack. Any feelings of unsteadiness will calm down shortly after you complete the test.
You will also have video head impulse testing (vHIT). This involves turning your head in short sharp movements both horizontally (up and down) and vertically (side to side).
You may also have cervical evoked myogenic potentials (cVEMP). This involves placing sticky electrodes on your neck and forehand. Loud sounds are played through headphones to stimulate your balance organs.
Any feelings of unsteadiness during testing will pass quickly (usually within just a few minutes). However, bring your anti-dizziness medication to your appointment. You may wish to take some after you complete the test.
None of the above tests will hurt, but if you have any concerns please speak to your clinician.
Why have you checked my eye movements?
We check eye movements as they are very closely related to how balance works. As your vestibular system senses movement to one side, a reflex reaction moves your eyes in the opposite direction.
However, if there is a problem in your inner ear, you may feel you are moving even when you are still. Your eyes will try to compensate for this, which results in an abnormal eye movement (beating of the eyes). This is known as a nystagmus.
To check your eye movements, we use a set of goggles with cameras in. These allow us to see your eyes clearly, even in the dark. The goggles allow us to track and record your eye movements using a computer. To do this you will need to keep your eyes open throughout the testing, even when in the dark.
When will I get my results?
We cannot give you any results at your balance testing appointment.
We will send your results to the consultant or GP who referred you for testing. They will make an appointment for you to discuss the results with them.
What are my treatment options?
If your results show that your diagnosis is related to an inner ear problem, you may be given rehabilitation exercises. These exercises help your body compensate for any vestibular dysfunction.
You may also be sent for physiotherapy or to a vestibular rehabilitation centre for help with your recovery.
You may need further tests to rule out other causes of your dizziness.
Can I drive home after my appointment?
No. Please arrange for someone to take you home after your appointment or use public transport.
Useful web sites
[Web sites last accessed 14 May 2026]
Contact details
If you have any questions or concerns about your balance tests, please contact the Audiology Department.
Audiology Department
Telephone: 01227 864252
Open 10am to 12 noon and 2pm to 4pm on Monday, Tuesday, and Thursday)
Email
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Patient Voice Team
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