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Balance and Falls Center

At the UCSF Balance and Falls Center our experts assess patients to determine potential causes of vertigo, dizziness and balance problems and to recommend treatments. Our assessment and treatment program is comprehensive in nature and includes videonystagmography (VNG) or electronystagmography (ENG), rotary chair, vestibular evoked myogenic potential (VEMP) and canalith repositioning.

Balance Assessment

Balance assessment protocol at UCSF is made up of a number of subtests that examine the effectiveness and interaction of your vestibular system (the inner ear), and screens the somatosensory (flex and pressure sensors in your feet), and vision system contribution to your overall stability and balance. The assessment will help us determine which system may be contributing to your specific symptoms and give direction for treatment. As specified by your referral or based on your symptoms and medical history, the assessment may include:

  • Videonystagmography (VNG)
  • Rotational chair
  • Vestibular Evoked Myogenic Potential (VEMP)
  • Video Head Impulse Test (vHIT)
  • Assessment/Treatment of Benign Paroxysmal Positional Vertigo (BPPV)
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Rotational Chair: The patient sits in a chair in a small, dark booth. Video goggles are placed near the eyes and a computer-driven chair rotates back and forth at various acceleration rates. The rotation stimulates the vestibular system and causes eye movements (nystagmus) that are recorded by a computer and monitored with an infrared camera. The rotary chair test is very useful when confirming a suspected loss of inner ear balance function in both ears and determining the extent of residual function. It is also helpful in providing information regarding status of central compensation in cases of unilateral or bilateral peripheral vestibular involvement.

VEMP: This is myogenic response from the muscles in a person’s neck (sternocleidomastoid) or eyes, in response to high level acoustic stimulation. Based on evidence, it is believed the VEMP provides information from the otoliths (saccule and/or utricle) and the vestibular nerve. During this test a patient will have surface electrodes on his/her head and neck. He/she will recline in a chair and contract the neck muscles while listening to a loud clicking sound.

vHIT: The video head impulse test analyzes the vestibular-ocular reflex in response to small head movements similar to that of natural daily motion. The patient wears a pair of lightweight video goggles that record eye movement on a computer system.

The VNG/ENG evaluation is separated into three subtests.

Oculomotor: The first subtest assesses the visual system for balance, called the oculomotor system. In this test, measurements of the various voluntary or controlled eye movements are taken. This is achieved by completing a series of exercises while visually following a dot on a light bar.

Positional/Positioning: The second subtest is called the positional/positioning test, focusing on the vestibular system, which is the balance structure of the inner ear. During this part of the test, movement of the head and/or head and body is executed in order to monitor how the vestibular system reacts to these movements and to changes in gravity.

Calorics: The final subtest is called the caloric test. This measurement determines how well the vestibular system responds by applying warm and cool air into each ear canal separately. Comparisons are then made of the vestibular system’s performance from one side to the other, and whether a possible weakness or hyper-response may exist within the inner ear. During the caloric test, it is not unusual to experience a sensation of movement which goes away immediately following the completion of the caloric test.

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To make an appointment, please call the number below for any necessary forms and have your primary care provider or specialist fax the forms back to us.

Getting Here

UCSF Balance and Falls Center
2380 Sutter St., First Floor
San Francisco, CA 94115-0340
Phone: (415) 353-2101
Fax: (415) 353-2883

Hours: Monday, Tuesday, Wednesday and Friday
8:30 a.m. – 5 p.m.
Hours: Thursday
10 a.m. – 5 p.m. (closed 12-1 for lunch)

What to Bring

    • Health insurance information including authorizations or referrals if not previously submitted
    • List of medications that you're allergic to
    • List of questions you may have
    • Recent test results related to your condition that have not already been submitted

Access Your Health Information Online

This clinic uses UCSF MyChart, an online patient service. Message your provider, request medication refills, view some test results and more.

Learn more about UCSF MyChart

Research and Clinical Trials


Parking at Mount Zion

Public parking is available in two parking garages near our Mount Zion campus. One is a UCSF garage at 2420 Sutter St.and the other is a public garage at 1635 Divisadero St. Entrances to both garages are on Sutter Street, between Divisadero and Broderick streets.

The 2420 Sutter St. garage is open 6 a.m. to 10 p.m., Monday to Friday, and closed on weekends and UCSF holidays. The rate is $6 an hour with a $30 daily maximum. The daily maximum for patrons with disability placards is $12.

For more information about parking in the 2420 Sutter St. garage, call (415) 514-8935.

The public parking lot at 1635 Divisadero St. garage is open from 5:30 a.m. to 9 p.m., Monday to Friday, and closed on weekends and major holidays. The rate is $2 each 20 minutes with a $28 daily maximum. UCSF parking vouchers are not valid at the 1635 Divisadero St. garage.

For more information about the public parking lot in the 1635 Divisadero St. garage, call (415) 441-5408 or visit

Other public parking garages are available nearby.

Metered street parking is rarely available.

Public Transportation

Mount Zion

UCSF Medical Center at Mount Zion is accessible via the following Muni bus routes:

  • No. 2*
  • No. 38*
  • No. 24

The No. 1 California bus route stops at the corner of California and Divisadero streets, which is three blocks north of Mount Zion.

For more information about Muni, visit

* Wheelchair accessible bus routes

UCSF Shuttles

Free UCSF shuttles travel between the Parnassus and Mount Zion campuses as well as other UCSF locations.

For more information about UCSF transportation, please call (415) 476-1511.

Assessment Overview

Balance assessments are completed at the UCSF Balance and Falls Center at 2380 Sutter Street, First Floor, San Francisco, CA 94115.

Please arrive on time in order to successfully complete the full evaluation. Please follow the balance assessment patient instructions. Your compliance with these instructions is very important for successful testing.

Balance Assessment Instructions

Please read the following instructions carefully. Certain substances can influence the body's response to the tests, reducing their value and validity. Your compliance with these instructions is very important for successful testing.


Please DO NOT TAKE any of the following MEDICATIONS for a period of at least 48 hours:

  • Anti-nausea medication (Dramamine, Compazine, Borine, Marezine, Vontrol, Phenergan, Thorazine, etc.)
  • Anti-vertigo medication (Antivert, Ruvert, Meclizine, etc.)
  • Tranquilizers (Valium, Librium, Atarax, Vistaril, Equanil, Miltown, Triavil, Xanax, Serax, Etrafon, Darcovet, Diazepam, etc.)
  • Narcotics and Barbiturates (Codeine, Demerol, Dilaudid, Morphine, Percodan, Phenaphen, etc.)
  • Sedatives (Nembutal, Seconal, Dalmane, Doriden, Placidyl, Quaalude, Butisol, Feldene, or any other sleeping pills)
  • Antihistamines (Chlor-Trimeton, Dimetane, Disophrol, Benadryl, Actifed, Teldrin, Triaminic, Seldane, or any over the counter cold remedy)


If you have any questions regarding medications please contact your prescribing physician or call the clinic at (415) 353-2101.


  • Do not consume any alcohol, including beer and wine.


  • Do not smoke or use any tobacco products.
  • Do not use makeup or skin oils, especially around your eyes.
  • Eat light meals.
  • Corrected vision is helpful for the test. Contacts should be worn if available.


If you have any questions prior to your appointment, please contact Audiology at (415) 353-2101.

Please review and submit the following forms at least 1 week before your appointment:

Related Information

Ways to Give

Condition Information

Clinic Team

Payal Anand
Payal Anand,
doctor of audiology
Molly Adler
Molly Adler,
doctor of audiology
Troy Cascia
Troy Cascia,
doctor of audiology
Kelli Goering
Kelli Goering,
doctor of audiology
Lauren Pasquesi
Lauren Pasquesi,
doctor of audiology