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Dizziness and Balance Assessment: ENG-VNG Testing

Dizziness, vertigo and imbalance are the second most common complaints heard in the doctor’s office.

NHI reports that balance issues account for 50% of accidental deaths in the population over 65.

NHI further reports nearly 300,000 hip fractures and 3 billion dollars in medical expenses are due to balance and related falls.

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of dizziness, can exist concurrently with other vertigo/dizzy etiologies and is the most treatable.

ENG-VNG (Electronystagmography/Videonystagmography) evaluation consists of a battery of tests used to assess the function of the peripheral and central vestibular systems. Electrodes (ENG) or video goggles (VNG) are used to measure the movements of the patient’s eyes to evaluate the vestibular oculormotor reflex response (VOR) to detect nystagmus. Nystagmus is the only physical sign uniquely linked to the vestibular system.

ENG-VNG testing additionally provides permanent, objective recordings, detects subtle abnormalities of reflex eye movements at the brainstem and is the only clinical test that can separate one labyrinth from the contralateral partner.

Clinical applications/reason for referral of the ENG-VNG test battery:

  • Evaluation post head trauma or neck injury, for suspected BPPV
  • Evaluation for suspected aneurysm or TIA
  • Evaluation for vestibular dysfunction including Meniere’s disease, vestibular neuritis, labyrinthitis
  • Evaluation for ocular, proprioceptive, metabolic and musculoskeletal disorders
  • Evaluation for CNS (including MS) disorders and CPA tumors
  • Evaluation for superior canal dehiscence
  • Evaluation for fistula