Vestibular Rehabilitation Unit
Vestibular / Balance appointments:
These can last between 30 minutes and 2 hours depending on which tests will be carried out. The balance appointment is run by a senior Audiologist trained in vestibular diagnostics and rehabilitation. Balance appointments can either be made direct from a GP referral, or from correspondence between the Ear, Nose and Throat department and Audiology and aim to establish the cause of a patient’s balance disturbance. The origin of balance disorders can be positional vertigo, a vestibular weakness, Ménière’s disease, a central pathology or idiopathic (no cause identifiable).
A detailed history will be taken of the nature of the balance problems, and then the appropriate tests will be carried out. These include, but are not limited to:
Video Nystagmography – a series of tests using goggles to measure the eyes in relation to balance. This test helps to diagnose the presence of a vestibular weakness and whether the problem is likely to be central or peripheral in nature.
Rotational Chair – This test involves the patient being sat on a motorised programmable chair, and moved in certain patterns. The movement of the chair stimulates the balance organs, and eye movements are again recorded. Results can help indicate if there is normal symmetrical function of both balance organs.
Caloric Irrigation – This test involves water (either cool or warm) being run into the ear canal to stimulate the balance organ in the inner ear. The stimulation of the organ causes the eyes to move in certain patterns, and using goggles these can be measured to compare their function, to determine if there is a weakness in either organ.
Posturography – testing how sensation from the legs and feet contribute to overall balance function. This can also assess where the centre of gravity lies and whether it is likely that there is a vestibular weakness present.
Dix-Hallpike manoeuvre – a postural test from seated to supine which is a diagnostic test for positional vertigo. If this indicates positional vertigo to be present, this can be followed with a series of head turns which aim to correct the problem.
Depending on the results of the tests performed, in some cases exercises can be issued to assist in rehabilitation.
A review is then booked 3 to 6 weeks after this appointment to review a patient’s progress.