Balance Diagnostic Assessment

Quick, targeted checks of your balance system to identify problems and recommend next steps.

What are balance diagnostics for?

A diagnostic balance assessment is designed for people whose symptoms need a more detailed investigation. It goes beyond initial screening, combining specialist hearing, ear, and balance tests to build a clearer picture of which parts of the system may be involved.

Symptoms checked:

Detailed investigation of the inner ear, hearing, eye movements, and reflexes that contribute to balance.

Why it matters:

A diagnostic assessment provides a clear understanding of which part of the balance system is affected, guiding accurate treatment or referral.

How it’s assessed:

Specialist tests, including hearing checks, middle-ear analysis, reflex testing, and advanced eye-movement recordings, are used to build a full picture.

Next steps:

Findings are reviewed with you in detail, and a written summary is provided. Where appropriate, recommendations for rehabilitation or onward referral are included.

What is included in a Balance Diagnostic assessment?

Medical History
Video Otoscopy
3D Tympanometry

A more advanced check of middle ear function using gentle changes in air pressure. This helps identify problems such as fluid, stiffness, or blockages that could affect hearing and balance. The addition of testing the response of these responses at multiple frequencies allows for a more detailed assessment for subtle differences in function.
Pure Tone Audiometry (Hearing Test)

This is the standard hearing test used to measure how well different tones can be heard at various volumes. You listen to a series of beeps through headphones and press a button whenever you hear a sound. The results show whether your hearing is within the expected range or if there are any areas of hearing loss.

Hearing and vestibular function both originate from the same organ in the ear, so changes in your hearing can be very useful in formulating an accurate diagnosis.
Vestibular Evoked Myogenic Potentials (VEMP)

cVEMPs (Cervical Vestibular Evoked Myogenic Potentials)
This test measures the response of a neck muscle to sound, helping assess part of the balance system known as the saccule and the nerve pathways that connect it to the brain. Stick-on sensors are placed on the skin, and you’ll be asked to gently turn or lift your head while listening to short sounds through earphones.

oVEMPs (Ocular Vestibular Evoked Myogenic Potentials)
This test records tiny responses from the eye muscles to sound or vibration, giving information about another part of the balance system called the utricle. Sensors are placed just below the eyes, and you may be asked to look upwards while the responses are measured.

Threshold and Multi-frequency VEMPs
In more detailed testing, VEMPs can be measured at different sound levels and frequencies. This provides a clearer picture of balance organ function and can help identify specific patterns linked to different conditions.
Six Canal Video Head Impulse Test (vHIT)

Small, quick head movements are used while tracking the eyes with special goggles. This measures how well the balance organs in each ear are working.

During the test you will be required to relax your neck and let the clinician move your head for you, whilst you remain looking at a visual target in front of you. The goggles can be quite tight, but only need to be worn for approximately 5 minutes.

All six semi-circular canals are assessed, allowed for a detailed look at the function of the inner ear balance organs and nerve pathways.
Diagnostic Videonystagmography (VNG)

Eye movements are recorded using goggle-mounted cameras while they following simple visual targets. This provides information on how the brain, eyes and inner ears are working together to maintain balance.

A diagnostic VNG assessment includes advanced testing methods to provide a deep-dive into the complex systems involved in maintaining balance including:
-Gaze testing
-Smooth pursuit
-Random saccade testing
-Headshake nystagmus test
-Saccadometry
-Ocular Counter Roll
-Optokinetic Test
Positioning Assessments

Specific head and body positions are used during the assessment, with eye movements carefully observed during and after each position. Special goggles are worn to record eye movements accurately, as this provides vital information for diagnosis. Different manoeuvres may be performed depending on the type of BPPV suspected. The tests are safe but do require a reasonable level of mobility, such as being able to move quickly from sitting to lying back.
Canalith Repositioning Maneuvers

If BPPV is identified, treatment can often be provided straight away. Specific maneuvers are chosen depending on which balance canal is affected. As with the positioning assessments, the maneuvers require a reasonable level of mobility, such rolling over and sitting up from a reclined position. The repositioning maneuvers are highly effective, and many patients experience relief after just one session.
Debrief of Findings

At the end of the assessment, the clinician explains the results and what they mean for your symptoms. If treatment has been carried out, the response is reviewed and further steps are discussed. Clear written information is provided for your records, and with your consent a copy can be sent securely to your GP or specialist. Advice is also given on what to expect over the following days, and whether any follow-up appointments may be helpful.

Balance Diagnostics

Clear answers and detailed investigation for dizziness or unsteadiness.

If you’ve been living with ongoing dizziness, repeated unsteadiness, or symptoms that haven’t improved with basic treatment, a diagnostic assessment provides a more in-depth look at how your balance system is working. This option goes beyond screening, using specialist tests to pinpoint which part of the ear or balance pathways may be affected.

Book Diagnostics

Balance Diagnostics

£320

A detailed diagnostic appointment that builds a clear picture of hearing and balance function. The session may include hearing tests, middle-ear analysis, reflex assessments, and advanced eye-movement recordings. Results are explained in detail, with a written summary and personalised advice on treatment or onward referral.

Flexible Assessment Options

We will only ever recommend or perform tests which are in your best interests. Your results are reviewed in detail, with time to answer questions and discuss options. Where treatment is possible, this can often begin right away. If a more comprehensive assessment is recommended, you’ll only need to cover the difference in cost, ensuring you don’t pay twice for similar tests.

Looking for a more detailed assessment?

Balance Diagnostic Assessment

What are balance diagnostics for?

Symptoms checked:

Why it matters:

How it’s assessed:

Next steps:

Balance Diagnostics

Balance Diagnostics

£320

Flexible Assessment Options

Click here to view our full range of balance assessment options

Any questions? Please get in touch!