Clinical Examination & Medical History

Your healthcare provider will start by asking detailed questions about your symptoms, including when they occur, how long they last, and what triggers them. A physical examination follows, focusing on:

• Checking for nystagmus, which is involuntary eye movement linked to balance issues.
• Gait and Sensory Assessment – Evaluating gait, sensory function, coordination, and muscle strength to detect neurological or sensory issues affecting balance.
• Performing specific maneuver tests to provoke vertigo and observe your response.

Hearing Evaluation

Because hearing and balance are closely linked, your hearing will be tested to identify any problems in your inner ear that may contribute to vertigo.

Videonystagmography (VNG)

This test tracks your eye movements using an infrared camera. Since your eyes and balance system work together, VNG helps pinpoint the source of vertigo by analyzing eye responses to visual stimuli.

Head Impulse Test (HIT)

HIT assesses your vestibulo-ocular reflex (VOR), which stabilizes your vision when your head moves. The test helps identify whether vertigo originates from problems in the inner ear or elsewhere.

Vestibular Evoked Myogenic Potentials (VEMP)

VEMP evaluates how well certain balance organs (called otolithic organs) in your inner ear and their neural pathways are functioning.

Caloric Test

By introducing warm or cold air or water into the ear canal, this test stimulates the inner ear and helps assess vestibular function, detecting any imbalance.

Subjective Visual Vertical (SVV)

SVV measures your brain’s ability to perceive vertical alignment, which is essential for balance. This test can detect problems in the brain’s processing of balance information.

Electrocochleography (ECochG)

ECochG records electrical activity in the inner ear and is especially helpful for diagnosing Ménière’s disease, a condition that causes vertigo and hearing loss.