Helping understand what may be causing your dizziness, vertigo or imbalance.
Vestibular function testing assesses how well different parts of your inner ear and balance system are working.
Our specialised assessments provide objective information that can help identify whether the vestibular system may be contributing to your symptoms and assist your doctor with diagnosis and management.
Our vestibular assessments are bulk billed for patients with a valid Medicare card and medical referral.
Please allow approximately 2 hours for your appointment.
Your assessment may include the following tests:
Video Head Impulse Test
What is it?
A quick, and non-invasive test used to assess the function of the vestibulo-ocular reflex (VOR), which helps stabilise your vision during rapid head movements. It allows us to evaluate the function of the semicircular canals in the inner ear.
What is involved?
You will wear a lightweight set of goggles with a high-speed camera and motion sensors that track head and eye movements in real time. You will focus on a target while your head is moved in small, quick motions left, right, up, or down, depending on the semicircular canal being tested.
What can it tell us?
vHIT can identify reduced function in individual semicircular canals and can help determine whether there is evidence of a unilateral or bilateral vestibular weakness.
Learn more about this test
Vestibular evoked myogenic potentials (VEMPs)
What is it?
VEMP testing is used to evaluate whether the gravity sensing organs and associated nerves are intact and functioning normally. Responses in these tests are measured from muscles in the neck and under the eyes.
What is involved?
You will be asked to lie down. Recording pads will be placed in various positions including your neck, under your eyes, forehead and chest. One test involves lifting and holding your head off the pillow while loud clicks are played in your ear. A second test involves looking upwards while vibration pulses are placed on your forehead.
What can it tell us?
VEMP testing provides information about the otolith organs of the inner ear (the saccule and utricle) and their associated vestibular nerve pathways. It can help identify reduced or absent vestibular function.
Learn more about this test
Videonystagmography (VNG)
What is it?
A series of tests that are performed while using an infrared camera to monitor and record your eye movement.
What is involved?
You will wear a pair of goggles while we ask you to follow a target that is either still or moving.
What can it tell us?
Eye movements can provide signs of vestibular dysfunction and/or neurological problems and are a key step in diagnosing vestibular disorders.
Diagnosing benign paroxysmal positional vertigo (BPPV)
VNG is also used to observe eye movements during Dix-Hallpike testing which assesses for the most common cause of vertigo, benign paroxysmal positional vertigo (BPPV).
Eye movements are recorded to characterise nystagmus (a jerky eye movement). This allows us to correctly diagnose which semicircular canal is affected so we can perform the appropriate treatment.
Auditory Brainstem Response
What is it?
The ABR measures how the nervous system sends an acoustic message from the ear to the brain.
What is involved?
You will be lying down and an earphone will play a series of clicks into your ear for roughly 2 minutes at a time. The good news is you do not need to do anything for this test and can even fall asleep. The test usually takes 8-10 minutes.
What can this tell us?
The ABR can help identify abnormalities along the auditory pathway and determine whether further medical investigation may be appropriate.
Audiometry (Hearing test)
What is it?
An assessment of your hearing levels. Hearing evaluations are an important part of vestibular diagnostics because the inner ear contains both hearing and balance organs. We also perform tympanometry and acoustic-reflex testing which can help detect problems in the middle ear as well as distortion product otoacoustic emissions (DPOAEs) – a quick, non-invasive test that measures the function of the outer hair cells in the cochlea.
What is involved?
Earphones are used to present tones at different pitches and levels for you to respond to when these sounds are heard. Bone-conduction involves sending the tone directly to the inner ear using a device behind your ear. Bone-conduction testing is used to determine if a hearing loss is related to the outer, middle or inner ear. Testing with words may include repeating words in quiet or in the presence of background noise.
What can this tell us?
Audiometry provides information about how well you can hear different sounds and frequencies. It can identify the type and degree of hearing loss and patterns of hearing change which are essential for diagnosing certain vestibular conditions such as semicircular canal dehiscence and Ménière’s disease. These tests also guide how we do and interpret the vestibular function tests.
Additional Tests for Ménière’s disease
If you require further testing to investigate the possibility of Ménière’s disease then we will arrange as part of your appointment. The additional tests that will be performed include;
Electrocochleography
What is it?
A test of the electrical activity generated by the cochlear and eighth nerve. The response generated by the cochlea is often increased in Ménière’s disease while the response from the eight nerve remains unchanged.
What is involved?
Ear drops are placed into the ear then drained out again before a lead with a recording ball is placed into the ear and gently onto the eardrum. A series of clicks are played into the ear. This test is fully automatic so you do not need to do anything.
What can it tell us?
The results of this test can identify changes in inner-ear responses that may be associated with Ménière’s disease. Electrocochleography
does not diagnose Ménière’s disease on its own, but can provide useful information alongside your symptoms and other test results to help build a clearer picture of what may be happening in the inner ear and is Ménière’s disease is likely or unlikely.
Caloric Testing
What is it?
Caloric testing uses changes in temperature within the inner ear to individually stimulate the horizontal semicircular canals (HSCCs). Unlike the video head impulse described above, we can test each canal individually.
What is involved?
You will lie comfortably while wearing specialised goggles that record your eye movements. Warm and cool air is gently introduced into each ear for approximately 60 seconds at a time. This may briefly create a sensation of turning or spinning, but the feeling is usually shortlived. Your eye movements are recorded using videonystagmography (VNG), as described above.
What can this tell us?
This test allows us to assess the function of the HSCCs to look for asymmetries or dysfunction. It can also be used in conjunction with the video head impulse testing to assist in Ménière’s diagnosis.
