Vestibular service (balance)

Vestibular Assessment

A vestibular assessment takes up to 1 hour 45 minutes. The combination of tests required will depend on your history and symptoms. The Audiological Scientist that you see will explain each procedure to you on the day, but if you would like any further information please contact us. The tests are designed to look at the way your brain combines information from your balance organs, vision and proprioception.

The audiologist will first take a detailed history from you; recording your balance problems, general health and lifestyle.

There will then be a series of short tests examining your balance function. The testing carried out is partly dependent on the individual patient case but is likely to involve:

• Assessment of your standing balance.
• Assessment of any abnormal eye movements on lying down quickly on the couch.
• Assessment of your eye movements when looking at or following a target, when moving your head, and when lying on the couch in different positions.
• Assessment of the balance function in each ear by introducing warm and cool water or air into one ear at a time and measuring your eye movements.

After testing, the audiologist will explain the results to you, speak to you about any management they can offer, and will write a full report back to your referring consultant.

Please note the following before attending the appointment:

• Wear clothing in which you will feel comfortable moving into various positions, for example laying down or on your side.
• Please avoid a heavy meal before the appointment, choosing a lighter snack instead.
• As there is a slight chance you may feel unsteady afterwards, if possible try to arrange for someone else to drive you home.
• If you are currently taking any prescription medication please could you bring a list of these with you to your appointment.
• Please stop any medications for dizziness at least 48 hours prior to your appointment as these can influence testing (Please note that if you are taking Betahistine (Serc) tablets, please continue to take these.). Some other medications can also influence testing, so if you are able to do so please also stop antihistamines, sedatives, anti-nausea medication and strong painkillers.
• Please also refrain from drinking alcohol, smoking or vaping for 48 hours prior to your appointment as these may also influence your test results.
• For most of the tests, your eye movements are carefully monitored by computer via a headset. Please refrain from wearing make-up around the eyes as this can interfere with the recording of your eye movements. Eye make-up may need to be removed.
• If you are short sighted and have the choice of wearing contact lenses or glasses, please wear your contact lenses as a preference.

You are welcome to bring a family member or friend to accompany you to your appointment for support.

There may be a student observing or taking part in the appointment. If you do not wish for them to be in the appointment, please advise reception on your arrival.

Vestibular rehabilitation

Some patients who have balance problems might benefit from a specific type of exercise therapy known as vestibular rehabilitation. This treatment is not suitable for all types of dizziness or balance problem. Those patients who can be helped by this treatment are usually seen initially by both an audiologist and a physiotherapist who will look at the patient's balance problem in detail. Most patients will be given simple exercises to do at home and will then be followed up by the physiotherapist who will update these exercises as necessary.

Vestibular rehabilitation requires an initial 1 hour appointment with follow up appointments, lasting 45 minutes. The number of follow up appointments will depend on your symptoms, your progress and your preference. Some follow up appointments can be conducted by phone or video, or you may be able to be transferred to a service closer to where you live.