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Vertigo and Balance Assessment
 Videonystagmography (VNG) is used to clinically evaluate patients with dizziness, vertigo or balance dysfunction. VNG includes the use of video cameras to record eye movements. The vestibular system monitors the position and movements of the head in order to stabilize retinal images. VNG provides an objective assessment of the oculomotor and vestibular systems.
VNG consists of three subtests: oculomotor evaluation, positioning/positional testing, and caloric stimulation of the vestibular system. Comparison of the results obtained assists in determining the source of dizziness or unsteadiness. This includes assessing the system responsible for rapid eye movements and refixation, the presence, absence and ability of fixation of spontaneous nystagmus, the ability of the oculomotor system to track a target within the visual field, the presence or absence of nystagmus associated with benign paroxysmal positional vertigo (BPPV), the presence or absence of nystagmus in various body positions, and if a side of lesion or weakness can be inferred from results of caloric irrigation. Results from this evaluation will assist the physician for appropriate diagnosis and referral and to distinguish whether the symptoms are associated with balance disorders of the ear.
The evaluation usually lasts about 60 minutes. Although some people experience some dizziness during the test, the dizziness is usually of short duration. In order to achieve the best test results, the following instructions should be followed:
- No solid foods for 2-4 hours prior to the test
- No coffee, tea or cola after midnight on the day of the test
- No aspirin or medication containing aspirin for 48 hours before the test
- No alcoholic beverages/liquid medication containing alcohol 48 hours before the test
- Discontinue all medication for 48 hour prior to the test, except “maintenance” medications for your heart, blood pressure, diabetes or seizures, and any medications deemed by your physician to be necessary. Medications can be resumed immediately following the testing procedure. The following medications should be discontinued 48 hours prior:
- allergy pills
- sleeping pills/tranquilizers/nerve or muscle relaxants (i.e. Valium, Libruim, Xanax, Robaxin, etc.)
- decongestants/antihistamines (i.e. Benadryl®, Sudafed®, Dimetapp®, Chlortrimeton®)
- pain pills
- diet pills
- dizziness pills (i.e. Antivert, Meclizine, Bonine, ear patches, etc.)
- aspirin or aspirin substitutes (i.e. Tylenol®, etc.)
- narcotics/barbiturates (i.e. Codeine, Demerol, Percodan, Phenobarbital, antidepressants)
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