Vestibular Testing

Stanford Dizziness Clinic

Why am I getting vestibular testing? If you feel dizziness, vertigo, or disequilibrium, it can be hard to know if the problem is coming from your inner ear (which helps detect motion), your brain (which helps interpret motion), or both. Vestibular testing helps us figure out where your dizziness is coming from so we can better plan your care.

What to Expect? Most people tolerate vestibular testing well. There are no serious risks, but some parts may make you feel dizzy for a short time. Let your audiologist know if you have concerns or sensitivities. They can adjust the tests to fit your needs.

How to Prepare

  • Take your regular medications. You can bring as-needed meds to use after testing.
  • Avoid eye makeup. It can affect test results.
  • Wear comfortable clothes.
  • You can wear contacts or hearing aids. Glasses may be removed during testing.
  • Eat only a small meal up to 2 hours before.
  • Bring someone to drive you home. Some people feel a bit dizzy after testing.

Videonystagmography (VNG)

  • This test checks how your inner ear and brain work together to help with balance.
  • You’ll wear goggles that track your eye movements while you:
    • Watch moving dots on a screen
    • Lay in different positions
    • Have warm or cool air gently placed in your ears (called caloric testing—this is optional)
  • If you have a strong history of motion sickness, concussion, or migraine, we may skip the air part (calorics).

Video Head Impulse (vHIT) Testing

  • This test looks at how well your semicircular canals (balance organs in your inner ear) are working.
  • You will wear goggles that track your eyes and head movements.
  • While looking at a fixed spot, your head will be gently moved in different directions by the audiologist.
  • This shows how well your ears respond to quick head rotations.

Vestibular Evoked Myogenic Potentials (VEMPs)

  • This test checks the saccule and utricle (balance organs in your inner ear), which sense gravity and movement.
  • Small sticky sensors will be placed on your forehead, under your eyes, and on your neck.
  • You will hear tapping sounds while looking up or lifting your head.
  • Your body’s balance reflexes will be measured through the stickers to see how well your ears respond to gravity.

Dix-Hallpike for BPPV

  • The Dix-Hallpike test checks for benign paroxysmal positional vertigo (BPPV), a common inner ear cause of brief spinning dizziness.
  • You will start sitting, then your head will be gently turned and you will be helped to lie back quickly with your head slightly tilted.
  •  The pattern of eye movement helps determine whether loose crystals are present and which ear is affected.
  • The test is brief, and any dizziness usually lasts less than a minute.

Rotary Chair

  • You’ll sit in a motorized chair that gently turns from side to side.
  • You’ll wear goggles that track your eye movements as the chair moves.
  • This test helps us understand how your inner ear responds to slow rotations.

Audiogram (Hearing Test)

  • Because the inner ear controls both hearing and balance, we check your hearing as part of vestibular testing.
  • Even if you don’t notice hearing problems, a hearing test can uncover issues that affect your balance.