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Balance and vertigo

Vestibular Service

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Our vestibular service offers Audiology direct referral vestibular clinics, combined Ear Nose and Throat Department (ENT) and Audiology Complex Balance Clinics as well as a private service. We have close links locally and regionally with ENT, the paediatric and transition programme, complex needs, The West of England Cochlear Implant Programme (WEHIP), the skull base and neuroma clinic, physiotherapy, neurophysiology and neurology. We are also able to offer Audiology direct referrals for Magnetic resonance imaging (MRI)

Frequently asked questions

Why have I been referred to the vestibular service?

You have been referred for vestibular (balance) function testing to investigate the cause of your dizziness, vertigo or imbalance.

Your sense of balance is controlled by the brain which brings together information from: your eyes, the movement sensors in your joints and the vestibular (balance) organs in your inner ears. If there is a change in the function of any of these systems you may feel dizzy, unsteady, or both. This may include feelings of unsteadiness or light-headedness and sensations of spinning, falling or moving. Even if the change in function was only temporary, you may still feel on-going symptoms of unsteadiness, light headedness and disorientation. Additionally you may experience hearing changes, nausea or fatigue.

Carrying out vestibular function testing will help to both aid in the diagnosis and treatment of your condition.

How can I be referred to the Vestibular service?

Please contact your GP for a referral in the first instance, unless you already have an 'open' appointment with us, i.e. you have been seen by this service within the past 6 months.

If you would like an appointment with our private vestibular service contact our department by telephone on 0117 342 5854 (option 2), or email

What do I need to do before my appointment?

If you have any specialist communication requirements please inform us as soon as possible.

Your ears need to becompletely free of wax. Your own GP surgery can usually check your ears and remove any excessive wax. Please arrange this with your GP surgery before the appointment.

Avoid alcohol 48 hours before the appointment. Continue to take medications as prescribed by your doctor.

Please be aware that failure to comply with any of the above requirements may mean re-arranging your appointment.

What do I need to do on the day of my appointment?

We will explain everything to you during the appointment and we will gain full consent for every test that we carry out. You do not have to do anything that you do not want to do. There are some tests we may not be able to carry out if you have a history of certain conditions e.g. epilepsy, angina/hypertension (depending on how this is controlled).

Please feel free to have someone accompany you in the appointment.

Please wear comfortable clothing as you may need to lie flat on an examination couch and move into different positions for the tests.

Please do not wear any eye make-up, including mascara, eyeliner and eye-shadow, as this can interfere with our eye movement recording equipment. It is fine to wear either glasses or contact lenses.

You may wish to consider someone driving you home, although most people feel fine after the tests. Allow plenty of time for parking, as this can be difficult, and we may not be able to see you if you are late for the appointment.

We are a teaching hospital, and there may be a trainee or student either present, observing or leading the appointment. Please let us know if you would rather that they are not present or are not leading the appointment.

What is involved in vestibular function testing?

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The vestibular function testing appointment will last between 90 minutes and 2 hours. We will begin with asking you some questions about your dizziness or balance problems and will ask about your previous medical history. A range of balance function tests will then be performed to determine whether your dizziness originates from the balance organs in the inner ears. For most of these tests you will be asked to wear a pair of goggles with a camera attached to observe and record your eye movements. This is because there is a reflex linking your eye movements with the balance organs in the inner ears.

The tests we carry out will depend upon your symptoms and may include some or all of the following: 

  • Measuring your standing ability on a solid surface and an unsteady surface with your eyes open or closed.
  • Recording your eye movements whilst you view the motion of an LED light in front of you.
  • Recording your eye movements with your head or body in different positions.
  • Recording your eye movements during small, fast head movements.
  • Recording your eye movements after a small amount of warm or cool water has been run into each ear canal in turn. In some instances air may be used instead of water.

How will I feel?

Some of the tests may make you feel dizzy or off-balance, however you should soon feel back to normal again. These tests should not trigger off further attacks of dizziness.

When will I know my results?

When the tests are completed the clinician will be able to discuss the results with you and give a verbal summary. Some results take some time to analyse and the clinician may not be able to give you all the results on the day. A full report will be given to the referring doctor and a copy will be sent to your GP.

What if I don't want to do some the tests?

Verbal consent must be given by you before we perform any tests. If you do not feel comfortable with some of the tests the clinician is describing please let them know before the test as alternatives can be arranged.

How do I change or reschedule appointments or find out further information?

Please contact our department by telephone on 0117 342 5854 (option 2), or email

Appointments are run at both St. Michael's and Southmead Hospitals. Please check your appointment letter for the address of your appointment.

Please view our patient information leaflet for Diagnostic Audiovestibular (DAV) or for the Vestibular evoked myogenic potentials (VEMP) test.

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