VNG Balance Evaluations

Vertigo, dizziness, and balance problems can be life altering. Many of our patients find that dizziness makes it difficult or impossible to perform even basic daily tasks. Even more frustrating, in many cases your physician may have a hard time identifying a diagnosis and effective treatment solution.

If you are experiencing vertigo or balance issues, your doctor may want to refer you for a videonystagmography (VNG) balance evaluation.

What is a VNG evaluation?

The VNG test is a Gold Standard test that is much less expensive and often more effective at identifying the underlying cause of dizziness, vertigo, and balance problems. This test is designed to identify problems with the inner ear, the coordination between your eyes and inner ears, as well as central nervous system problems that may be contributing to your symptoms.

What tests will be performed?

At our clinic, we perform a comprehensive test protocol to identify problems that may be leading to your balance and dizziness symptoms:

Vision (Ocular Mobility) Testing

This testing measures your ability to track visual stimuli. This includes your ability to hold your gaze on a target, to track targets smoothly, and to track random visual movements. Problems with visual tracking may indicate central nervous system problems with the vestibular pathway between your eyes and your brain.

Optokinetic Visual Testing

This is an additional test to measure your eyes ability to track stimuli. During this test, bars of alternating colors will move across the screen and we measure your ability to "catch" certain colored bars with your eyes. Similar to other visual tests, this test will give clues to possible central or neurological problems, as well as problems with the nervous system related to the vestibular pathways to the brain.

Positional Nystagmus

During this test we will cover up your eyes so that you are in the dark. Our infrared camera system will record eye movements while we place you in different sitting and lying down positions. This testing can measure abnormalities with your inner ear balance system as well as the pathway from your ears to your brain.

Dix Hallpike Testing

During this test we will quickly move you from a sitting to a lying down position. This test is designed to identify any abnormal movement of crystals in your inner ears that could lead to vertigo when moving your head in different positions. Positive results on this test typically indicate the presence of Benign Paroxysmal Positional Vertigo (BPPV), which is an easily treatable and benign condition that our vestibular therapy team can help you treat in just 1-3 sessions.

Caloric Testing

During this test, we will put cool air and warm air into your ears (one temperature and one ear at a time). This air causes your inner ear to become active, and helps us measure the health of your inner ear vestibular system. Abnormal results on this test often indicate a vestibular hypofunction, or an underperforming inner ear balance system. Treatment for this condition is typically vestibular therapy.

Preparing for VNG testing

Prior to your VNG test, our team will send you a list of restrictions including certain foods and medications you will need to refrain from prior to testing. Our goal is to measure the pure function of your inner ear and balance systems, and some substances can affect those systems and cause test results to be inaccurate. 

The entire VNG evaluation typically lasts about 90 minutes and can cause some dizziness. This dizziness usually subsides within a short period of time. It is advised that you bring someone with you who can drive you home afterward if you are unable to drive or do not feel well after the tests.