Our services
The Vestibular Evaluation
A thorough, specialist assessment that finds the real source of your dizziness — and turns it into a plan.
Why the Evaluation Matters
Dizziness and imbalance have many possible causes, and they often look alike from the outside. The single most important step in getting better is figuring out which problem — or combination of problems — is actually driving your symptoms. That's what the vestibular evaluation is for.
Rather than handing out generic exercises and hoping, we take the time to assess your balance system carefully, identify the cause, and design treatment around what we find. For some conditions, like BPPV, the evaluation and the first treatment can even happen in the same visit.
What Your Evaluation Includes
Your first visit is comprehensive. Depending on your symptoms, it typically includes:
- A detailed discussion of your symptoms and history — when symptoms started, what triggers them, how they affect your daily life, and what you've already tried.
- Assessment of your eye movements and visual tracking — your eyes reveal a great deal about how your balance system is working.
- Evaluation of inner-ear (vestibular) function — how well each part of your balance system is doing its job.
- Balance and walking assessment — how steady you are under different conditions.
- Positional testing — specific position changes used to identify BPPV and other position-triggered dizziness.
- Examination of neck mobility and function when it's relevant to your symptoms.
By the end, the goal is a clear picture of what's causing your symptoms and a concrete plan for addressing it.
A Closer Look: Infrared Goggles
Some assessments use infrared video goggles, which let us observe and record subtle, involuntary eye movements (called nystagmus) that aren't visible to the naked eye. These goggles improve diagnostic accuracy, help identify specific vestibular disorders, and give us valuable insight into how your balance system is functioning.
Will the Evaluation Make Me Dizzy?
Possibly — and if it does, that's often part of how we find the answer.
Many vestibular tests are designed to briefly reproduce your symptoms so we can see exactly which movements or positions trigger them. It can be uncomfortable for a short time, but any symptom provocation is carefully monitored and typically settles quickly. Reproducing your dizziness, when it happens, helps us understand its cause and choose the most effective treatment.
We'll explain what we're doing at each step, and we go at a pace that respects how you're feeling.
How to Prepare
A few simple things help your evaluation go smoothly:
- Medications. If possible, avoid taking Meclizine (Antivert) before your visit, as it can affect the accuracy of testing. Nausea medications such as Zofran are generally fine and may make testing more comfortable. If you're unsure whether to take a medication beforehand, contact us first — and never stop a prescribed medication without checking with your prescriber.
- Clothing. Wear comfortable clothing and flat, supportive shoes, since you'll be moving and we'll assess your balance and walking.
- Eye makeup. If you can, skip heavy eye makeup (like thick mascara or false lashes) on the day of your visit — it can interfere with the infrared goggles.
- Bring your information. A list of your current medications and any relevant prior test results or records (from an ENT, neurologist, audiologist, or ER visit) can be helpful.
- Consider a ride. If you tend to feel very dizzy or motion-sick, you may be more comfortable arranging for someone to drive you, since testing can temporarily stir up symptoms.
What Happens After Your Evaluation
Once we understand what's going on, you'll leave your evaluation with:
- A clear explanation of what's causing your symptoms, in plain language.
- An individualized treatment plan built around your specific findings and goals.
- A customized home exercise program, in most cases — consistency with it is one of the biggest factors in recovery.
- Coordination with your physician if your evaluation suggests additional medical testing or input would be helpful.
Practical Details
- Referral: None required. You can book directly.
Frequently Asked Questions
Why might you repeat tests another provider already did?
Even when a test looks the same, it's often used for a different purpose. Doctors frequently use vestibular tests to establish or rule out a diagnosis; we use many of the same tests to understand how your symptoms affect your movement, balance, vision, and daily life. Repeating them helps us establish a baseline, see how your brain is compensating, choose the right exercises, set the right challenge level, and track your progress over time.
Do I need a diagnosis before I come in?
No. Sorting out the cause is part of what the evaluation is for. You're welcome to come in with no diagnosis at all.
Do I need a referral?
No referral is required. If your evaluation suggests you need additional medical testing or consultation, we can communicate with your physician and help coordinate next steps.
Will I start treatment at the first visit?
Often, yes. For some conditions — BPPV in particular — treatment can begin right after the evaluation. For others, we'll map out the plan and begin your program.
What should I bring?
A list of your medications and any relevant prior records or test results. Comfortable clothing and flat shoes are ideal.