Vestibular (Balance and Dizziness) Service
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The Vestibular team consists of Audiological Physicians, Clinical Scientists and Audiologists who work closely alongside ENT, Neurology and Physiotherapy departments to assess and manage patients with balance problems.
Balance (vestibular) assessments take place at St Georges Hospital. Assessments can occur as part of a one stop clinic. This involves taking a detailed history of your problem, carrying out specialised hearing and balance assessment and rehabilitation if appropriate to do so. This means that you could spend anything from one to four hours in our department.
Our clinic is able to perform a wide range of specialist vestibular (balance) assessment and rehabilitation including:
There are a number of different specialist auditory and balance tests which may be carried out depending upon your symptoms. These can include some or all of the following;
Tests of eye movement using video recording or electrodes (Video / electro-nystagmography) This test is used to record a range of eye movements and the way you react to being turned around.
Caloric testing; In this test each ear will be irrigated (flushed out) with warm and cool water in turn for 30 seconds. This may be associated with a sensation of dizziness, which will last for no longer than five minutes. This test allows us to establish if there is a difference in the way your left and right ears are working.
Tests for positional vertigo (BPPV); Vestibular evoked myogenic potentials, Vestibular induced nystagmus test, Computerised head thrust test; These are relatively new tests and allows us to explore the vestibular system in more detail.
Pure Tone Audiometry Standard hearing test performed in a sound-treated room. The test is used to identify hearing threshold levels of an individual.
Tympanometry An objective assessment of the condition of the middle ear by introducing a small change in air pressure within the ear canal using a soft ear tip.
Preparing for the test – substances to avoid
- It is important that you have your ears checked for wax at your GP surgery before your appointment. Some procedures cannot be carried out if you have excessive wax in your ears.
- Avoid make-up, especially eye make-up. This may make it more difficult for our eye measurement systems to record your eye movement.
- Avoid alcohol or sleeping tablets the night before the test, but preferably at least 24 hours before.
- Please try to have a light meal or breakfast and normal drinks before the test if your appointment is in the morning. If it is the afternoon please have a light lunch and normal drinks.
- If you are on anti-dizziness medication already, the doctor who referred you for this test may have told you to stop taking the tablets for 48 hours prior to your appointment time. If he/she has not done this, please let us know as this type of medication can interfere with the test results. Examples include prochlorperazine (for example, Stemetil, Buccastem ) or Sturgeron. However, do not stop this, or any other medication, unless you have been advised to do so by your doctor.
What next? The audiologist carrying out the tests will prepare the report and this will be available to the referring doctor at your next appointment with them. Or, if you have been referred for testing during the one-stop balance clinic, you will get the chance to discuss your results and management with the doctor on the same day.
The balance assessments should help identify the most appropriate treatment for your condition. After your balance assessment and consultation with the doctor, you may be offered vestibular rehabilitation. This involves an individual programme of specific exercises.
This service is used in individual and / or group sessions to treat certain types of dizziness and other disorders of the balance system. However, it is not appropriate as a treatment for all the different types of disorders that might lead to dizziness and / or balance problems.
For example, treatment manoeuvres are offered if you are diagnosed with specific type of positional vertigo.
Referrals can be accepted from GPs or specialist doctors and need to be addressed to the Audiological Physicians.
Appointments are extremely valuable. If you cannot attend your appointment, please phone us so that a new appointment can be offered and the cancelled appointment offered to someone else.
Appointment Line; 020 8266 6363
Department of Audiological Medicine
St. George’s Hospital
London, SW17 0QT
Tel.: 020 8725 1151
Fax: 020 8266 6255
Minicom: 020 8725 3019