& Balance

Dizziness is one of the most common complaints heard by healthcare providers. It is also very complex, having many potential causes.

Problems with the Inner Ear

Dizziness is one of the most common complaints heard by healthcare providers. It is also very complex, having many potential causes.

When someone experiences dizziness, especially vertigo (a spinning sensation), the vestibular system is often the cause. The vestibular system is your inner ear balance organ, which includes the fluid-filled semicircular canals and the gravity-sensing otolith organs (saccule and utricle). If the vestibular system becomes damaged, vestibular disorders can result.

Common Symptoms

Motion sickness
Increased risk of falling
Blurred vision
Involuntary eye movements (Nystagmus)
Blurred vision with head movement (Oscillopsia)

Risk Factors for Developing
Vestibular Disorders

Age (40+ years old)

Cardiovascular disease

Chronic ear infections


Gender (women)

Hereditary factors

History of migraine

Infections (bacterial or viral)

Medications (e.g., aminoglycosides, chemotherapy)

Trauma to the ear, neck, and/or head

At Capital Institute of Hearing & Balance, we have the expertise and specialized equipment to thoroughly assess the inner ear to determine its impact on dizziness and balance.

Comprehensive Assessment

Because dizziness is so complex, a comprehensive assessment is often necessary.

The purpose of a vestibular assessment is to determine if the vestibular system is responsible for a patient’s symptoms and may also provide some insight into other potential causes.

Possible Tests Include:

Balance screening

Vestibular Evoked Myogenic Potentials (VEMPs)

Dynamic Visual Acuity (DVA) test

Videonystagmography (VNG)

Dix Hallpike test

Rotary chair

Other tests, such as the Vertebral Artery Screening Test (VAST), Cervical Dizziness Test, Head Impulse Test (HIT), Side Lying Test, and/or Auditory Brainstem Responses (ABR) may be performed as appropriate depending on your symptoms and case history.

Preparing for the Vestibular Evaluation

Avoid taking the following types of prescribed and over-the-counter medication within 48 hours of your appointment, as they may interfere with testing.

Medications to avoid before evaluation:

Anti-vertigo and anti-nausea medication (e.g., Meclizine, Antivert, Dramamine, etc.)

Sleeping pills (Melatonin is okay)

Pain medication

Anti-anxiety, anti-depressant, and mood disorder medication

Allergy or cold medication, with the exception of nasal sprays


If you are concerned about temporarily stopping some, or all, of your medications, please discuss your concerns with your prescribing physician. Bring a list of your medication and supplements (prescribed and over-the-counter) with you to your appointment.

Other Preparations:

Avoid alcohol, tobacco products, and illicit drugs for 48 hours prior to testing.

Avoid high-caffeine beverages (e.g., energy drinks, espresso) the day of testing. These may affect test results.

Provide your audiologist with prior reports and test results related to your symptoms.

Arrange for transportation home. Even though most patients feel fine after testing, some may feel fatigued and/or a bit disoriented.

Get a good night’s sleep. You will be required to be alert and keep your eyes open throughout much of the testing.

You cannot wear your glasses during the test; wear contacts if you have them.

Wear no eye makeup or false lashes; if you have tattooed eye makeup, bring white eyeliner to cover it for testing. The test requires that we are able to target your pupil to track your eye movement. If dark eye makeup is worn on the lashes, lids, or brows, it can interfere with those measurements.

Have nothing to eat at least 2 hours before testing, unless you are diabetic (in which case, you may eat something light). Although most patients tolerate the testing well, some will feel nauseous or queasy. Keep liquids to a minimum.

Wear comfortable clothes and shoes.