Service

Dizziness & Balance

Diagnosis and treatment of acute and chronic balance disorders using video nystagmography (VNG) and positional maneuvers.

Rotational vertigo, oscillatory vertigo, positional vertigo—the causes can originate in the inner ear, the vestibular nerve, or the central nervous system. We systematically diagnose the cause and, whenever possible, treat patients directly in our office.

When do patients come to see us?

These are the symptoms we most commonly evaluate at our clinic:

Episodes of vertigo

Sudden episodes, often triggered by certain head movements or when lying down. Most common cause: benign paroxysmal positional vertigo — usually treatable in a doctor’s office.

Persistent vertigo

A feeling of unsteadiness when walking or standing, difficulty concentrating. In these cases, we specifically look for causes in the vestibular system and the auditory nerve.

Dizziness with hearing loss or tinnitus

A combination of symptoms often points to an inner ear condition (e.g., Meniere's disease). We combine vertigo and hearing tests in a single session.

Dizziness after an infection or a cold

Vestibular neuritis (inflammation of the vestibular nerve) is a common complication—we confirm the diagnosis and adjust the treatment.

Here's how the examination works at our clinic

A structured process from the initial consultation to a concrete treatment plan—you’ll always know what comes next.

  1. Structured Initial Consultation

    Please describe the triggers, duration, and accompanying symptoms. We will use specific questions to narrow down whether the causes are peripheral or central.

  2. Clinical examination

    Examination of eye movements (nystagmus), positional tests (Dix-Hallpike), and examination of the middle ear and eardrum.

  3. Instrumental Diagnostics

    VNG (videonystagmography) for the objective recording of eye movements, supplemented by an audiogram and, if necessary, a head impulse test.

  4. Diagnosis and Treatment

    You will receive a clear and easy-to-understand diagnosis. In cases of positional vertigo, we perform the appropriate repositioning maneuver immediately—symptoms often improve significantly during the session.

Diagnostics and Methods

  • Videonystagmography (VNG)Objective recording of eye movements during caloric stimulation — the gold standard for distinguishing peripheral causes.
  • Positional maneuvers (Epley, Semont)Treatment of canalithiasis in benign paroxysmal positional vertigo — usually effective immediately, without medication.
  • Audiometry and TympanometryAuditory pathway testing to distinguish between inner ear disorders such as Meniere's disease or sudden hearing loss.
  • Head impulse test and Frenzel gogglesExamination of the vestibulo-ocular reflex — useful for differential diagnosis in cases of acute vertigo.

Frequently Asked Questions

How long does a vertigo examination take?
The initial examination, which includes a medical history, physical examination, and vestibular function testing, usually takes 30 to 45 minutes. If positional vertigo is diagnosed, the repositioning maneuver can be performed immediately afterward—we allow an additional 15 minutes for this.
Do I need to do anything to prepare for the exam?
Please bring a list of your current medications and any previous medical records. If medically appropriate, please refrain from taking any anti-dizziness medication for 24 hours prior to the VNG—otherwise, the test results may be less reliable.
Will I be allowed to drive after the exam?
You may experience brief dizziness after repositioning maneuvers or thermal stimulation. We recommend that you have someone drive you home or take a taxi—just to be on the safe side.
When is treatment by an ENT specialist sufficient?
When the cause is peripheral vestibular (inner ear, vestibular nerve), we are usually the right place to turn to. If central causes are suspected (e.g., neurological disorders), we refer patients to the appropriate specialty—and we coordinate the diagnostic process together.

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