How to access our Balance service
Your first step should be to visit your General Practitioner (GP). In some parts of our area you may be seen by an audiologist in a local GP practice. Either they, or your GP will investigate your balance problems and might then refer you to the audiology department, or to see and ENT (Ear, nose and throat) consultant.
How to contact our Balance Service
All Balance appointments across our hospital sites are booked by our admin team at the Royal Gwent Hospital.
Information about your appointment
We will assume your consent to have any of these procedures carried out when you attend the appointment. Please feel free to say during the appointment if you do not wish the tests to continue.
We actively encourage you to bring a friend or family member to all appointments. Please inform us by telephone or when you arrive in the clinic if you would prefer to be seen on your own.
If you require any communication support please telephone the department with details of your preferred language and we will do our best to arrange this for you.
Your appointment will be with a fully qualified Audiologist who has experience in testing balance function.
Before your appointment:
- We recommend that you do not drive immediately after your appointment. You may wish to arrange for someone to accompany you.
48 Hours before your appointment:
- Stop taking medication prescribed to control your dizziness. Continue to take medication for other conditions as normal.
- Do not consume alcohol or recreational drugs.
On the day of the appointment:
- Do not wear eye make-up.
After the appointment:
- You may take any medication you have been prescribed for your dizziness.
- For up to a couple of hours, you may feel unsteady, but after this period you should be able to continue your normal routine.
During your first appointment:
The Audiologist will ask you questions relating to your ears, your health and your balance in order to understand the problems that you are facing. It is important that you explain the reasons why you have come for an assessment so that the audiologist can tailor the appointment to your needs. The Audiologist will also discuss the situations in which your balance is causing a problem. This information will help us to decide how we can support you.
During your appointment, we will carry out all or some of the following tests:
Tests of Standing Balance
The Audiologist will observe you standing with your eyes open and closed and with your feet in different positions.
Video-nystagmography
It is not possible to record information directly from the balance organs because they are situated deep inside your head. Instead, we find out information about your balance organs from your eyes, because there is a link between them. You will wear goggles which contain cameras to watch and record your eye movements.
For some of the tests we will ask you to look at lights, and for some you will have your eyes covered. If you do not feel able to wear the goggles, we can use sticky sensors placed on your face to record your eye movements instead.
Dix Hallpike test
This involves moving from sitting to lying down and then to sitting again. The Audiologist will support you while you are moving and will look at your eyes while you are lying down. This is used to look for a common type of dizziness called Benign Paroxysmal Positional Vertigo (BPPV). If we find that you have BPPV, we can recommend a treatment straight away.
Following your first appointment, we may recommend returning to the Audiology Department for further testing. You will have the opportunity to decide whether you are happy to go ahead. This will usually be one of the following:
Hearing test
You will be asked to listen to sounds through headphones placed over your ears and respond when you hear them. The Audiologist can then assess the quietest sounds which you are able to hear.
Caloric test
This allows us to record from the balance organ of each ear separately and to compare them to see if one is not working properly. During the test, you will be wearing the goggles to record your eye movements and we will use water to warm or cool each ear in turn.
Vestibular Evoked Myogenic Potential (VEMP)
This allows us to record from the balance organ of each ear separately and to compare them to see if one is not working properly. It is not as reliable as the caloric test, but can detect certain balance problems and can be used with people who cannot have water in their ears. During the test, you will listen to loud clicking noises, while the computer records a muscle reflex in your neck.
During the course of the appointment, if there is anything that you are unsure about, please do not hesitate to ask.