Balance function assessments

Some dizziness and balance problems come from problems with your inner ear or its nerves. This is known as your vestibular (balance) system.

To help identify the cause of your dizziness, vertigo or balance problems, you may be referred to the Statewide Tertiary Adult Audiology Service for a balance function assessment.

Paediatric services are provided at Fiona Stanley Hospital and Fremantle Hospital.

These services are also available to paediatric patients living within the SMHS catchment (PDF 2MB) at Fiona Stanley Hospital and Fremantle Hospital.

Before your assessment

To avoid your assessment being cancelled, please:

• avoid caffeine, alcohol and certain medications as advised by your doctor for 24 to 48 hours before testing
• don’t wear eye makeup for tests involving eye recording – this information will be in your appointment letter
• wear comfortable clothing.

Small sensors may need to be taped to your skin for some tests. If you are allergic to sticking plasters/tape, please let your audiologist know.

Please arrange for someone to drive you home after the assessment as you may experience some mild dizziness. After that you can resume normal activities.

At your assessment

The full assessment to check how your balance system is working usually takes 90 to 120 minutes.

Your assessment may include some or all of the following tests. The tests are safe and painless, although some motions or sounds may cause temporary and mild dizziness.

A balance audiologist (an expert in hearing loss and balance disorders) will guide you through each step.

Videonystagmography

Videonystagmography (VNG) checks your balance function by measuring eye movements you can’t control. If these movements happen when they shouldn’t, you may have a problem in your inner ear.

While wearing goggles which record your eye movements, we will ask you to follow a moving light with your eyes. At times, your audiologist may need to gently change your head position.

Warm and cool air (or water) may be also placed in your ear canal for about a minute. This is to investigate if your inner ears are working together or if one is working more than the other. Please note this may briefly cause mild dizziness.

Video head impulse test

The video head impulse test (vHIT) checks how well your eyes can stay focused during head motion

For this test, your audiologist will gently and quickly turn your head while you wear lightweight goggles that record your eye movements.

Vestibular evoked myogenic potentials

For a vestibular evoked myogenic potentials (VEMP) test you will either sit or lie down. As you hear clicking sounds through earphones, sensors placed on your neck and eye muscles will record any tiny muscle responses you make.

If you are allergic to sticking plasters, please let your audiologist know.

Rotary chair test

This test measures how well your eyes and inner ear work together to help your balance.

You will sit in a dark room on a slow-moving motorised chair – it will feel like spinning gently in an office chair – while small sensors monitor your eye movements. This test is only performed if your audiologist feels it is necessary.

After the assessment

After a detailed analysis, your results will be sent to your referring doctor.

Find out more

Find information on dizziness (external site) and vertigo (external site).

Visit the following websites:

• American Academy of Audiology (external site) – search for vestibular assessment or balance function testing.
• American Balance Society (external site) for information on balance disorders.
• Johns Hopkins Medicine (external site) – search balance testing or vestibular assessment.
• Mayo Clinic (external site) – search for balance testing, ENG, VNG or VEMP.

Referral information

You will need a referral from your general practitioner (GP) or specialist to access this service.