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Balance testing for dizziness

If you’re experiencing symptoms of dizziness, such as spinning sensations, lightheadedness, whirling or feelings of movement when you’re still, your consultant may refer you for some balance tests. Depending on your symptoms you may also be referred for hearing tests or a combination of both. Balance tests and hearing tests both help to determine whether or not your symptoms are being caused by an issue in your ear.

Balance tests are designed to gently challenge your vestibular system in order to see how you react in different situations. For example, some of the tests will examine the movements of your eyes in response to various stimuli because your eyes are an important part of keeping you balanced.

Some of these tests may temporarily make your symptoms worse as your balance system is challenged and you’re being asked to do things you’ve probably been avoiding in fear of making your dizziness worse. It’s important to try and complete the balance tests to the best of your ability as the more information they can provide, the more accurate the diagnosis.

ENG/VNG Tests (Electro Nystagmography/Visual Nystagmography)

ENG or VNG refers to a group of tests that are designed to monitor eye movement (nystagmus) using electrodes (ENG) or goggles (VNG) placed on your head.

The caloric test is one of these tests and it’s one of the most important balance tests for determining whether a vestibular problem exists. You’ll be asked to lie back on the chair and then cold and warm water is poured into your ear whilst your eye reactions are being recorded. Eye movement can indicate whether or not there is any damage within the balance system.

The test may bring on symptoms and can be a little uncomfortable but it shouldn’t last more than 30 minutes.

Other tests will challenge your vestibular system in different ways and this might include you moving your head quickly, following moving dots, watching a black and white sequence on a screen and chair movements.

The room might be dark for these tests and you may also be asked questions as they’re being performed or asked to do a task such as counting backwards in 3’s from 100. This is to keep you alert while the tests are taking place.


A posturography is a very common balance test and widely used to determine balance problems. You will be asked to take off your shoes and stand on a platform and when you’re ready, a series of tests under various different conditions will begin. For example, you will be asked to close your eyes, watch a moving screen, look left, right, up or down and whilst this is happening, the platform may move.

The length of time all of the tests will take can vary depending on which tests your consultant has ordered, however, they typically last between 1hr and 2hrs.

The results of your balance test will be sent back to your consultant for an evaluation and you will meet to discuss findings and treatment options.

Preparing for your test

The tests are designed to provoke your symptoms and as such, you will be asked to stop taking any medication that suppresses your symptoms.

Depending on the severity of your dizziness, you may also be advised not to eat a 2-3 hours before the tests in case they make you nauseous. Or you may be advised to eat a light breakfast/lunch. Caffeine should also be avoided.

Do not take sleeping tablets or consume alcohol 24 hours before your tests.

If you have excessive ear wax, you may be asked to get this removed prior to your appointment as some tests can’t be performed with wax build-up.