The Balance Clinic London
Your balance is controlled by three things: What you see, sensory input from your muscles and joints, and the vestibular system of the inner ear. The brain processes information from these three inputs and co-ordinates your balance.
If you are experiencing dizziness or imbalance, your physician can refer you to our balance clinic in London. We will perform a vestibular function test, which will determine whether or not it’s being caused by a problem in your inner ear.
All of our audiologists have either BSc or MSc qualifications in Audiology as well as registration as either Clinical scientists in Audiology with the HCPC or Clinical Audiologists with the RCCP. All have been thoroughly examined and assessed to ensure they are working to the highest possible clinical standards.
Our team has over 30 years of combined experience delivering diagnostic hearing and balance services to ENT consultants both in the NHS and private clinics.
What is vestibular testing?
Vestibular testing examines your balance through a range of methods. Your balance tests will be conducted by one of our expert audiologists, Mr Rony Ganguly or Ms Isobel McGown. Between them, they have more than 25 years’ experience in the assessment of dizziness and vestibular problems.
A typical session of vestibular testing will last for approximately 2 to 3 hours. It incudes:
- Video Nystagmography (VNG)
This is a method of recording reflex eye movements (nystagmus) that naturally occur when your vestibular system is stimulated. You will wear a pair of lightweight goggles with infrared cameras, which will record the movement. During the first part of the test you will be asked to follow moving targets on the wall with your eyes and to fix your gaze in different positions.
- Positional tests including Dix-Hallpike
This involves lying in different positions, as well as sitting up and lying down to see if nystagmus is contributing to your dizziness.
- Video Head Impulse test (VHIT)
This test also involves wearing a pair of lightweight goggles. You will be asked to focus on a target while we measure your eye movements during small but quick head movements.
- Bi-thermal Caloric tests
The last of the balance tests requires putting cool and warm water in the ear canal for one minute to stimulate the inner ear and measure the response. This may cause a mild sensation of dizziness
- Vestibular evoked Myogenic Potentials (VEMP)
Unlike VNG and rotary chair testing, VEMP testing does not measure nystagmus. Small surface electrodes are placed on a muscle on your neck, your sternum (breastbone) and your forehead. You wear headphones, similar to those worn for a hearing test, and a loud clicking noise is played while you look over your shoulder. We test both the left and the right ear and it takes approximately 20 minutes.
You will be given a full explanation of your test results on the day, and a full written report with recommendations will be sent to your ENT consultant or physician. If required, you may need to begin balance rehabilitation.
Preparing for vestibular testing
Once you have been referred to us for vestibular testing, there are some things you should know and prepare for.
- Ask a friend
The purpose of the balance tests is to evaluate your vestibular (balance) system. Some of the tests may give you a sensation of motion. It is not uncommon for you to feel fatigued for the remainder of the day and it is recommended that you ask someone to accompany you to and from the appointment.
- Dress comfortably
The tests take approximately 2 to 3 hours, so please wear comfortable clothing.
- Consult your physician about any prescribed medication
- Always consult your physician before discontinuing any prescribed medication. Certain medications or substances may alter the vestibular test results. To prevent this from happening, please DO NOT take any of the following 48 hours prior to your appointment:
- Anti-dizziness or anti-nausea pills
- Alcoholic beverages
- Beverages that contain caffeine
- Sleeping pills or tranquilizers
- Over the counter allergy or cold medications
DO NOT STOP any mediation for heart/blood pressure disorders, endocrine (thyroid, hormonal) disorders, blood/sugar disorders for diabetes, seizure disorders, anxiety medications, or medications for depression. If you are in doubt, please contact your physician BEFORE YOU STOP taking the medication.
- Eat a light meal 3-4 hours before your test
If you are a diabetic or have low blood sugar, please follow your regular mealtime routine as well as your normal injections or pills.