Videonystagmography (VNG) records eye movements during selected vestibular and oculomotor tests. It can add objective information to a dizziness or balance assessment, but it is not a single test that gives an exact diagnosis for every patient.
What VNG cannot do alone
VNG does not independently exclude stroke, tumour, multiple sclerosis, or another central disorder. It does not by itself diagnose Ménière disease, and it does not measure a hearing-loss pattern. New neurological warning signs, sudden hearing loss, inability to walk, fainting, chest pain, or a severe new headache require urgent assessment.
What may be included in a VNG assessment
- Oculomotor testing: records selected gaze, saccade, and smooth-pursuit tasks. An unusual pattern must be interpreted in clinical context and may require further assessment.
- Positional and positioning tests: record nystagmus in selected positions and can support canal-specific BPPV assessment when the history fits.
- Caloric testing: compares low-frequency horizontal-canal responses from the two ears under controlled stimulation. It can provide evidence of asymmetry or reduced responses, with known technical and clinical limitations.
Not every patient needs every component. The protocol depends on the clinical question, physical safety, ear status, medicines, and other findings.
How results are interpreted
VNG may provide evidence of vestibular asymmetry, positional nystagmus, bilateral reduced caloric responses, or an oculomotor pattern that deserves further review. These findings are not diagnoses in isolation. Results are interpreted with timing and triggers, neurological and eye-movement examination, ear examination, hearing assessment, migraine features, medicines, and imaging or referral when indicated.
Low- to mid-frequency hearing loss is documented by audiometry, not by VNG. Ménière disease is a clinical diagnosis that uses the attack history, fluctuating ear symptoms, and hearing assessment; a VNG result alone cannot confirm it.
VNG and BPPV
Video recording may help document positional nystagmus, but the manoeuvre is selected from the affected canal, side, nystagmus pattern, movement safety, and clinical assessment. The Bangalore Manoeuvre is described for selected anterior-canal BPPV and is not a general substitute for the Epley manoeuvre.
Preparing safely
Follow the individual instructions provided when the test is booked. Tell the clinic about all medicines, migraine, neck or back limitations, ear disease, pregnancy, mobility or fall risk, and recent alcohol or sedative use. Do not stop prescribed medicines without explicit instructions from the clinician who arranged the test. Temporary dizziness or nausea can occur during parts of the assessment; arrange an escort and avoid driving if symptoms remain active afterward.
Questions worth asking
- What clinical question is this VNG intended to answer?
- Which components are planned and why?
- What result would change the treatment plan?
- If VNG is normal, what other causes still need consideration?
- Do hearing tests, positional examination, neurological review, or imaging have a role in this case?
VNG appointments in Hardoi
Prime ENT Center provides VNG evaluation in Hardoi by prior appointment. Availability, preparation, suitability, report timing, and current charges should be confirmed directly with the clinic. Call +91 73930 62200 or contact the clinic on WhatsApp.
References
- NIDCD: balance disorders
- American Academy of Audiology: classification of Ménière disease
- AAO-HNSF Clinical Practice Guideline: BPPV (Update)
Medical disclaimer: This page provides general test information and does not diagnose an individual.
