The inner ear’s vestibular organs and associated nerves and brain centres serve many functions and can be affected by a number of outside systems. A comprehensive history is taken along with a selection of several different kinds of specialised tests which are carried out by a specialised audiologist.


These include:

  • Dizziness questionnaire: this helps identify frequency and severity of dizziness symptoms and associated lifestyle changes.
  • Hearing assessment: This is an important part of vestibular diagnoses because of the close relationship of the inner ear hearing and balance organs. These assessments include: pure tone audiometry (PTA), speech discrimination testing and middle ear function testing (tympanometry and acoustic reflexes).
  • Electrocochleography (ECochG): This is a technique of recording electrical potentials generated in the inner ear and auditory nerve in response to sound stimulation using an electrode placed in the ear canal or tympanic membrane. This test is used to detect elevated inner ear pressure or for the testing or monitoring of inner ear and auditory nerve during surgery.
  • Vestibular evoked myogenic potentials (VEMP) assessment: This test is used to evaluate whether the otolith organs (Saccule and Utricle) and vestibular nerves (Inferior and Superior) are intact and functioning normally.
  • Dix-Hallpike assessment: This is a diagnostic manoeuvre used to identify Benign Paroxysmal Positional Vertigo (BPPV).
  • Videonystagmography (VNG): This is the most common test administered to people with dizziness, vertigo and/or balance disorders. It is a group of eye movement tests that looks for signs of vestibular dysfunction or neurological problems. It measures nystagmus and other eye movements using an infrared video camera mounted inside goggles that the patient wears.
  • Video Head Impulse Testing (vHIT): Testing the vestibulo-ocular reflex (VOR) and semicircular canal function in the peripheral vestibular system