If a physician can’t identify the cause of vertigo, they may refer you to an ENT doctor for further testing, known as a vestibular test battery. This test takes around two hours and can show whether vertigo is occurring because of problems with the vestibular system in your ears.
Ahead of any vestibular testing, you might need to prepare in the following ways:
- Make plans to get home after the tests that don’t involve driving, as you may feel dizzy.
- Follow a doctor’s instructions around any regular medications you take, as you may need to avoid some before the test.
- A doctor restricts what you eat or drink before the test, including alcohol.
- Forgo wearing eye makeup, to help make your eye movements more visible.
Vestibular testing might only sometimes give clear results, per Monteith. “Vestibular tests can be abnormal if people are asymptomatic and nondiagnostic in people with symptoms.”
Rotary Chair
During a rotary chair test, you’ll put on special goggles and sit in a motor-driven chair that tilts to the left and right as you keep your eyes open. The goggles track your eye movements, showing how your vestibular system and eyes work together.
Modified Clinical Test of Sensory Interaction on Balance (mCTSIB)
This test checks how your sense of touch, inner ears, and vision interact to trigger dizziness. You’ll stand without shoes on a firm surface followed by a soft foam surface, staying as steady as you can on both for 30 seconds. The doctor might ask that you do this test with closed and open eyes.
Vestibular Evoked Myogenic Potentials (VEMP)
This shows how two organs in the ear, the saccule and utricle, work. The doctor places electrodes on your neck and has you turn your head from right to left while wearing headphones and focusing on a particular visual target. The electrodes measure how the neck muscles respond to sound signals.
VNG
“If the physician refers the patient to an ear, nose, throat, or ENT doctor, the ENT will perform a careful ear exam and sometimes a hearing test. Rarely, ENTs administer a specialized inner ear balance test called videonystagmography (VNG) or electronystagmography (ENG).”
This test measures nystagmus, which can point to inner ear balance issues and highlight ear-related causes of vertigo. In doing so, it can show the health of nerves in the brain linked to eye movement control. During a VNG, a person sits in a dark room wearing specialized goggles.
A VNG has three parts:
- Follow moving lights with the eyes and look at fixed lights
- Move the head and body into different positions to check whether these trigger nystagmus.
- Caloric testing, in which an ENT checks the vestibular (or balance-related) system in each ear using cold water or air
A VNG may cause some discomfort during the test and dizziness afterward.
Dynamic Visual Acuity Testing
This can help a doctor measure your ability to use your vestibular system while moving your head. Sitting in front of a computer, you’ll have to identify a target both while sitting still, while moving from side to side, and while moving up and down.
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