Preparing for Vestibular Testing
We want your visit to be as quick and easy as possible. There are some simple things you can do to help:
Do not eat for 3 hours before your appointment (unless you’re diabetic, in which case, don’t skip any meals).
Do not drink excessive fluids for 3 hours before testing. No coffee, tea, or cola after midnight on the day of the test.
No alcoholic beverages 48 hours before the test.
Do not wear make-up, mascara or moisturizer of any kind.
Although lingering dizziness symptoms are rare after testing, you may want to arrange a driver or an alternative mode of transportation just in case, especially if you know yourself to be more prone to severe dizziness or anxiety.
Avoid wearing contact lenses as they are prone to drying out the eye, making testing uncomfortable
Please let your audiologist know if you are experiencing any back or neck problems
Some medications interfere with testing and can lead to inconclusive results. Even though we suggest to stop taking certain drugs, always check with your doctor before stopping prescription medication, especially if you’ve been taking it for a long time. It can be helpful to bring a list of medications with you to your appointment.
Please take care to stop taking the following medications 24 hours before testing:
On the day of testing, avoid alcohol, caffeine, tobacco and recreational drugs of any kind.
The following medication should not be discontinued:
Blood pressure pills (aside from
Diabetes pills and insulin
OUR VESTIBULAR BATTERY
Videonystagmography/ Electronystagmography (VNG/ENG)
The VNG/ENG battery is considered by many to be the gold standard test for vestibular assessment. Our state-of-the-art equipment can capture even the most subtle eye movement abnormalities, many of which would go undetected during a bedside evaluation.
It is a 1 hour comprehensive test of balance function. In order to monitor your eye movements, you will be asked to wear a pair of goggles or you will have sticker electrodes around your face throughout the testing.
During the first part of the test you will be asked to follow a light from side-to-side and up-and-down.
Here, we are looking for any abnormal eye movements with changing head and/or body position. You will be asked to turn your head to each side and sit-up for 30 seconds.
The Dix-Hallpike Manoeuvre
During this part of the test we are looking for positional vertigo. You will be asked to lie flat on your back with your head extended in one direction. This will be repeated with your head extended in other other direction.
The last part of the test involves putting warm and cool air into your ears. The air will stream into your ears for 25-30 seconds and this may cause some dizziness, however, it will not last.
This is an important part of the assessment as it tests the balance system of each ear separately so that we can compare the intensity of the response from each side.
Please note: dizziness from this test typically subsides within a very short period of time and most patients feel well enough to drive themselves home. As a precaution, we recommend that you ask a friend or family member to drive you to the appointment in case the dizziness takes a bit longer to subside.
Vestibular Evoked Myogenic Potentials
The Vestibular Evoked Myogenic Potential (VEMP) test is used to evaluate the balance organs that help with up-and-down and forward-and-backwards movements. Responses are measured from the neck muscles (cVEMP) and the eye muscles (oVEMP) by placing sticker electrodes on the neck and on the cheek.
In total, the c and oVEMP testing takes 45 minutes to 1 hour to complete.
You will have sticker electrodes placed on your forehead, neck and upper chest as well as a foam insert placed in your ear.
You will be asked to turn and hold your head to one side when you hear a sound.
You will have sticker electrodes placed on your forehead, under your eyes/cheek and upper chest as well as a foam insert placed in your ear.
You will be asked to look up when you hear a sound.
VIDEO HEAD IMPULSE TEST (vHIT)
The Video Head Impulse Test (vHIT) is used to assess how well the eye can focus when the head is moving. In order to test this function, you will wear a pair of goggles and be asked to focus on a target in front of you. The clinician will then move your head side to side while you stare at the target. The goggles measure your eye and head movements.
A vHIT takes approximately 30 minutes to complete.
Diagnostic Hearing Assessment
At the Lake Huron Audiology, we offer comprehensive diagnostic hearing assessments for all of our patients, experiencing dizziness symptoms. This will help provide us information not only regarding your hearing, but will provide more insight to your vestibular concerns.
What Is Included?
We examine your ears, including the external ear canal and the eardrum, to look for signs of blockages (e.g. earwax) as well as ear-related problems that might require medical follow-up (e.g. ear infections).
If significant earwax is present, the audiologists a have access to medical-grade microscopes and suction devices for removing it.
We use a machine called a tympanometer to assess how your eardrums are moving. When an eardrum is too floppy or too stiff, it can indicate certain middle ear problems that usually require medical follow-up.
We may also play loud sounds in your ear to assess acoustic reflexes.
This is the step that people most commonly expect when they come in for a hearing test. We play a series of beeps/tones and ask you to respond when you hear one. This way we can determine your hearing thresholds for each ear individually, across the range of frequencies/pitches that are important for speech understanding.
We use the results of this test to establish the severity and type of hearing loss. A hearing loss can be the result of damage to the inner ear and/or auditory nerve (sensorineural hearing loss), problems with the middle ear (conductive hearing loss), or both (mixed hearing loss).
This part of the assessment is divided into two main parts. During the first part, you will be asked to repeat words as we vary the loudness. The purpose is to establish the softest level at which you are consistently able to repeat the words back correctly.
During the second part, we measure your accuracy when repeating words at a comfortable listening level. We also complete tests to establish your most comfortable listening level for speech (MCL), as well as your uncomfortable listening level (UCL; the maximum level you can listen to sounds before they become uncomfortably loud).
At the discretion of the audiologist, other tests may be completed to better understand your individualized needs. An example of this is the speech in noise test (QuickSIN), which is used to evaluate your ability to function outside of a quiet environment.