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Richter Family Clinic for Balance Disorders

It is estimated that up to 15 percent of all children have issues with dizziness, and 50 percent of children with atypical hearing levels have dizziness or balance issues. These symptoms can be the result of a vestibular (inner ear) disorder.

Signs and symptoms of vestibular disorders include:

  • Involuntary eye movements (nystagmus)
  • Difficulty walking in the dark
  • Reduced hearing thresholds or tinnitus (ringing in the ears)
  • Motion sickness or sensitivity to movement
  • Nausea, vomiting, and diarrhea
  • Clumsiness or unsteadiness when walking
  • Inability to stand on one foot
  • Inability to ride a bike without training wheels
  • Poor posture: a tendency to fall, lean, or tilt over
  • Ear pressure
  • Headaches or migraines with nausea
  • Slower achievement of developmental milestones, such as riding a bicycle, swimming, hopping, and stair climbing
  • Vision problems
  • Fatigue
  • Fear, anxiety, and panic
  • Difficulty with concentration and memory
  • Difficulty focusing, especially when turning to look at something
  • Skipping words or letters while reading
  • Inability to write legibly
  • Poor progress in school
  • Difficulty participating in exercise including sports
  • Difficulty focusing, especially when turning to look at something

What to Do

If your child is experiencing any of these signs or symptoms, a battery of tests might be needed to determine a cause, which can lead to appropriate treatment. Please consult with your child’s primary care physician or pediatrician. If a vestibular disorder is suspected, your child can be referred for a medical evaluation with the Division of Otolaryngology (ENT) and/or for assessment with the Audiology department.

Vestibular Disorder Tests

The Shirley and Sam Richter Clinic for Balance Disorders at Rady Children’s Hospital is proud to offer a full complement of vestibular tests. Not all children will require every test.

  • Videonystagmography (VNG): This test documents a child’s ability to follow objects with their eyes and how well the eyes respond to information from the vestibular system. Children are guided through a variety of head and body positions and either cooled or warmed air or water is introduced to their ear canals in order to determine if each ear is responding appropriately.
  • Rotary Chair: This test is completed in a darkened room using a computerized swivel chair, with the child either seated alone or on a parent/guardian’s lap. The child wears a pair of video goggles that record eye movements as the chair swivels back and forth.
  • Vestibular Evoked Myogenic Potentials (VEMP): While a sound is played through earphones, the child is asked to move their head or eyes for periods of time. This movement is recorded from electrodes that have been placed on the head and body.
  • Video Head Impulse Testing (vHIT): Goggles are placed on the child’s head, and the examiner gently turns the child’s head in different directions.
  • Computerized Dynamic Posturography (CDP): The child will stand barefoot facing an ocean scene that surrounds them and be asked to stand as still as possible. The ocean scene and the platform the child stands on move for portions of the test. The child’s eyes will be closed for part of the test.


3665 Kearny Villa Road, Suite 400
San Diego, CA 92123

Contact Us

For more information, call 858-966-8100.