Main purpose The main aim was to analyse the clinical profile of children with and without hearing impairment referred with various vestibular related symptoms attending a tertiary balance clinic over six months. Children undergoing pre-cochlear implant assessment were also included.

Design of study A thorough clinical history and evaluation of auditory and vestibular assessment was undertaken. Diagnosis of the medical condition was made on the basis of all the above.

Results One hundred and twenty four consecutive patients (55 female and 69 male) were included. The age range was 9 months to 18.5 years (mean age 9.41 years). Multiple professionals referred these patients.

Associated conditions: Ten patients had a history of migraine, 8 had cyclical vomiting, 8 had CHARGE syndrome, 7 referred post-meningitis had labyrinthitis ossificans. Three patients sustained head injury.

Signs:- Two patients had positional nystagmus: one with history of head injury, the other sustained vibration injury to the labyrinth caused during fairground rides. Head impulse test was positive bilaterally in seventeen patients, indicated by the presence of catch-up saccade, a clinical feature of vestibular failure.

Objective Vestibular assessment:- Electronystagmography showed central vestibular abnormalities in 18 (14.5%), 66 had normal vestibular function and 41 had vestibular hypofunction. Seventeen had bilateral vestibular failure.

Implications and relevance of results In children, numerous aetiologies of dizziness and balance problems may have a similar clinical picture. The symptoms of non-vestibular disorders can masquerade those of vestibular disorders and vice-versa. Close multispecialty working is vital for positive clinical outcome.