Concierge neuro-otology · London
Vestibular evoked myogenic potentials (VEMPs), the vestibular test that measures saccule and utricle function.
VEMPs (cervical and ocular) measure the otolith organs — saccule (cVEMP) and utricle (oVEMP) — the only vestibular test that reveals these. Foundation of vestibular migraine, Meniere’s and superior semicircular canal dehiscence (SSCD) workup.
Why patients choose us
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The right hands
We route you to a consultant neuro-otologist or accredited audiovestibular scientist — the person who runs the test and reads it decides the answer.
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Often answers same-day
cVEMP and oVEMP thresholds and asymmetries can be discussed straight after the test, with the written report to follow.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
What a VEMP test is, in one glance.
Six anchor facts on the only routine test that reads saccule and utricle function.
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Definition
A short-latency evoked potential of the vestibular otolith organs — the only routine test that measures saccule and utricle function.
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30–45 minute test
Bedside protocol with EMG electrodes, delivered in a quiet audiology suite.
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Cervical (cVEMP) + ocular (oVEMP)
cVEMP reads saccule via the inferior vestibular nerve; oVEMP reads utricle via the superior vestibular nerve.
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Reveals otolith function
Complements semicircular canal tests — the otolith limb of the labyrinth is otherwise invisible.
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Complements vHIT and caloric
Combined with video head impulse and caloric testing to map the full vestibular apparatus.
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Foundation of SSCD workup
A lowered cVEMP threshold is a diagnostic hallmark of superior semicircular canal dehiscence.
Indicative pricing
What private VEMP testing costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A combined cVEMP + oVEMP in our network: £450–£750, with thresholds discussed the same day.
| Test type | Indicative range | Typical duration | Report turnaround |
|---|---|---|---|
| cVEMP (cervical) | £280–£450 | 30 min | Same-day |
| oVEMP (ocular) | £280–£450 | 30 min | Same-day |
| cVEMP + oVEMP bilateral | £450–£750 | 45 min | Same-day |
| VEMPs + vHIT combined | £650–£950 | 60 min | Same-day |
| Full vestibular battery (VEMPs + vHIT + caloric + SVV) | £900–£1,500 | Half-day | Same-week |
| VEMPs + neuro-otology consultation | £650–£1,100 | 75 min | Same visit |
Prices vary by clinic, whether cVEMP and oVEMP are combined, and whether a same-visit neuro-otology opinion is included. We come back with a firm quote within one working day.
The problem
A VEMP result is only as good as who reports it.
Thresholds and asymmetry ratios are the answer — and the neuro-otologist interpreting them decides how those numbers translate into a diagnosis and next step. We route you to a specialist, not a generalist.
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Sound-induced vertigo?
We arrange urgent VEMPs and, if the threshold is lowered, high-resolution CT for SSCD.
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Suspected Meniere’s?
We fold VEMPs into a full vestibular battery with audiometry and vHIT.
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Vestibular migraine work-up?
We rule out peripheral causes so migraine management can proceed with confidence.
The journey
From vertigo consultation to structured plan — what happens, in order.
One clinician from first message to report — often within days.
Phase 1 · Before
Concierge, off-stage for you
Phase 2 · On the day
~30–45 minutes at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
Vertigo consultation
A short, confidential form and a consultation to characterise the vertigo, triggers and pattern.
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On the day
Sit upright with head turned (cVEMP)
You sit up and turn your head away from the tested ear so the sternocleidomastoid muscle is activated.
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On the day
Look up with contralateral gaze (oVEMP)
You look up and across to the opposite side so the inferior oblique muscle is activated.
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On the day
Sound stimuli delivered via earphones
Short, loud tone bursts or clicks are delivered — 500 Hz air-conducted, sometimes bone-conducted.
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On the day
EMG electrodes record response
Surface electrodes over the neck (cVEMP) and just below the eye (oVEMP) record the myogenic response.
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After
Structured report
Thresholds, amplitudes and asymmetry ratios reported vessel-by-vessel by a consultant neuro-otologist.
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After
Structured plan
Onward vestibular-rehabilitation, ENT or neuro-otology pathway, integrated with vHIT and caloric results.
Typical end-to-end: 3–7 days. Urgent cases: same day.
What it shows
When VEMPs are the right test.
VEMPs answer a specific question — how are the otolith organs and their nerves behaving. These are the patterns we see most.
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Absent cVEMP (saccular dysfunction)
Loss of the cervical response points to saccule or inferior vestibular nerve dysfunction.
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Absent oVEMP (utricular dysfunction)
Loss of the ocular response points to utricle or superior vestibular nerve dysfunction.
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Lowered threshold (SSCD)
A pathologically low threshold is a hallmark of superior semicircular canal dehiscence.
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Meniere’s pattern
Characteristic amplitude and threshold changes support a Meniere’s diagnosis.
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Vestibular neuritis pattern
Selective superior or inferior nerve involvement helps localise the lesion.
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Vestibular schwannoma pattern
Asymmetric responses may raise suspicion and prompt MRI of the internal auditory meatus.
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Post-labyrinthectomy loss
Confirms surgical ablation of otolith function on the operated side.
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Red flag: lowered threshold + Tullio phenomenon — urgent SSCD imaging
Combine with high-resolution temporal-bone CT the same week.
Treatment options
What the result opens up.
The onward pathways VEMP findings most often trigger, from rehabilitation to surgery.
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Vestibular rehabilitation
Structured physiotherapy programme targeting central compensation and gaze stability.
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Anti-migraine therapy
Trigger avoidance plus prophylactic medication for vestibular migraine.
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Diuretic + salt restriction (Meniere’s)
First-line medical management to reduce endolymphatic pressure.
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Intratympanic steroid
Local dexamethasone for refractory Meniere’s or sudden vestibular loss.
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Intratympanic gentamicin
Chemical labyrinthectomy for disabling unilateral Meniere’s vertigo.
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SSCD surgical repair
Middle-fossa or transmastoid plugging or resurfacing for confirmed dehiscence.
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ENT / neuro-otology referral
Onward specialist review for surgical candidates and complex diagnoses.
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MDT review
Coordinated audiology, ENT, neurology and radiology decision-making.
Our vetted London network
A small panel of clinics, we picked them.
Partners across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinic in our network.
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Consultant neuro-otologists or accredited audiovestibular scientists
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Bárány Society and BSA-compliant VEMP protocols with EMG normalisation
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Same-day report, with tracings available for onward review
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Onward vestibular-rehabilitation, ENT or neuro-otology pathway
Red flags
When VEMPs matter most.
The presentations where a VEMP result changes the pathway — the ones we watch for and expedite.
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SSCD with Tullio phenomenon
Sound- or pressure-induced vertigo with a lowered cVEMP threshold — urgent CT temporal bones.
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Meniere’s with drop attacks
Sudden unprovoked falls (Tumarkin) demand urgent neuro-otology review.
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Vestibular schwannoma
Asymmetric VEMPs with unilateral hearing loss — MRI internal auditory meatus.
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Post-labyrinthectomy vertigo
Ongoing instability after ablative surgery — reassess central compensation.
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Persistent postural-perceptual dizziness
PPPD — vestibular rehabilitation and cognitive-behavioural pathway.
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Post-concussion syndrome
VEMPs help distinguish peripheral from central post-traumatic dizziness.
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Post-COVID vestibular dysfunction
Emerging pattern of otolith involvement after SARS-CoV-2 infection.
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Bilateral vestibulopathy
Absent VEMPs bilaterally — consider ototoxicity and autoimmune causes.
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Cerebellar disease
Central signs on examination — MRI brain and neurology referral take priority.
Reading your report
A VEMP report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Indication and clinical background
Your details, the vertigo pattern, and the vestibular risk factors that shape interpretation.
- 02 Technique
Stimulus, electrodes and EMG normalisation
Which stimuli were used, electrode montage, and how EMG amplitude was normalised.
- 03 Findings
Thresholds, amplitudes and asymmetry ratios
Side-by-side cVEMP and oVEMP values with interaural asymmetry ratios.
- 04 Impression
The conclusion: read this first
Normal, saccular or utricular loss, SSCD pattern, and the concrete next step — read this first.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about VEMPs.
Quick answers on what the test measures, cVEMP vs oVEMP, cost, referrals, safety and turnaround.
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What do VEMPs actually measure?
VEMPs measure the function of the otolith organs — the saccule (via cVEMP) and utricle (via oVEMP). They are the only routine vestibular test that reads these two organs, which sit alongside the semicircular canals in the inner ear.
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What is the difference between cVEMP and oVEMP?
cVEMP is recorded from the sternocleidomastoid muscle and reflects saccule and inferior vestibular nerve function. oVEMP is recorded from the inferior oblique muscle just below the eye and reflects utricle and superior vestibular nerve function. A full otolith assessment needs both.
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How much does a private VEMP test cost in London?
A combined cVEMP and oVEMP in our network is typically £450–£750; a full vestibular battery with vHIT and caloric testing raises the price. We confirm a firm figure within one working day.
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Do I need a referral for VEMPs?
Most clinics accept self-referral for vestibular testing. We can arrange a fast-track private GP or neuro-otology consultation if a formal referral is needed for insurance or onward pathway.
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Are VEMPs safe if I have hearing loss?
Yes — the test uses short tone bursts and is safe. If there is severe conductive hearing loss, bone-conducted stimuli may be used instead of air-conducted, and the neuro-otologist will adapt the protocol accordingly.
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How quickly will I get results?
Thresholds and asymmetry ratios can usually be discussed immediately after the test, with a formal written report from the reporting neuro-otologist within 24–48 hours.
Sources
Guidance this page is built on.
- Bárány Society. Consensus on vestibular-evoked myogenic potentials.
- British Society of Audiology. Practice guidance on VEMP recording.
- American Academy of Otolaryngology–Head and Neck Surgery. Clinical practice guidelines.
- European Academy of Otology and Neurotology. Position statements.
Reviewed 2026-07-30 by Pulse Atlas Editorial Board, . Next review 2027-07-30. Reading time ~4 min.
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In practice, in London
Where vestibular evoked myogenic potentials sits in a private London pathway
With vestibular evoked myogenic potentials, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. The NHS route for vestibular evoked myogenic potentials is thorough, but the queue is real. Most patients we speak with have been told to expect anywhere from a handful of weeks to several months, depending on their local trust and how the referral is graded. Going private in London usually collapses that window to a matter of days — often the same week if the diary allows. It isn’t about jumping a queue so much as buying time back while you still have the flexibility to plan around it.
The mechanics are straightforward: a consultant appointment, any tests done at a nearby CQC-registered site, and a written report back within a few days. London’s density of private diagnostics — Marylebone, the City, Chelsea, Canary Wharf — means most patients can find something that fits around work without a cross-town trek. For vestibular evoked myogenic potentials specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
Where a good concierge earns its keep is in the matching. There are dozens of consultants in London who see vestibular evoked myogenic potentials — but not all of them are the right fit for every case. We narrow it down based on subspecialty, insurer coverage, the specific question being asked, and whether continuity into treatment matters. The right first appointment saves you from repeating yourself later.