What is Electronystagmography Test for Vertigo?

Vertigo is a sensation of spinning, feeling disoriented, imbalanced, nauseous, motion sick, & dizzy. Patients often feel like they are spinning or their surroundings are spinning, even when they are perfectly still. Vertigo is also sometimes accompanied by migraine headaches & ringing in the ears (tinnitus).

Vertigo is one of the most common complaints faced by people of all ages, especially among middle-aged people. Vertigo is generally not fatal, & is not a cause to worry about your health. However, if your Vertigo symptoms begin to interfere with your everyday life & activities, then it may be time to visit a doctor & start looking out for Vertigo treatment methods.

Vertigo symptoms:

Vertigo symptoms vary depending on your exact Vertigo cause & your medical history. However, there are certain vertigo symptoms that are common across all patients.

Some of the most popular Vertigo symptoms are:

• Dizziness
• Nausea
• Motion sickness
• Headaches of migraine intensity
• Vomiting
• Spinning sensations
• Ringing in the ears also called tinnitus
• Loss of balance
• Disorientation
• Hearing loss (in the case of Meniere’s Disease & Vestibular Neuritis)

In case of mini-strokes, or central vertigo, Vertigo symptoms can also be associated with loss of consciousness, confusion, delirium, or pain in the chest.

Vertigo causes:

Vertigo causes include a range of conditions. Some of these are mentioned below:

• BPPV (Benign Paroxysmal Positional Vertigo), caused by the deposition of loose calcium crystals in the semicircular canal of the inner ear. These are normally in the middle ear, & are motion-sensitive, thus causing problems with the brain’s detection of motion signals sent from the vestibular system located inside the inner ear
• Meniere’s Disease, caused by an abnormal amount of fluid inside the inner ear (also known as endolymphatic fluid). This excessive fluid causes pressure changes in the ear, leading to balance problems, dizziness, nausea, motion sickness, headaches, & tinnitus(ringing sound in the ears)
• Vestibular Neuritis, which is an infection of the vestibular nerve that carries balance-related signals from the vestibular system to the brain & vice-versa. When this nerve gets infected or inflamed, balance signals can’t properly reach the brain & the person experiences dizziness, nausea, & motion sickness.
• Which is also an inner ear infection caused by viruses or bacteria, & leads to the inflammation of the vestibular nerve, causing dizziness & vertigo symptoms.

Other Vertigo causes include head injuries, blunt force trauma, inner ear surgeries, & side effects of certain medications.

Vertigo Diagnosis:

Doctors diagnose Vertigo based on your exact symptoms, their severity & intensity, frequency, & your medical history. Since there are different types of vertigo with specific symptoms & areas of interest, it is essential for your doctor to accurately diagnose your Vertigo to give you a proper vertigo treatment plan.

To diagnose Vertigo efficiently, your doctor will give you a variety of tests.

These tests include:

• The Dix-Hallpike maneuver, in which your doctor performs a few simple maneuvers to check if you feel dizzy afterward. If you do, that is a sign that you’re indeed suffering from Vertigo.
• Head Impulse tests, in which your doctor rotates your head in certain ways to check for dizziness & any abnormal, rapid eye movements, also called nystagmus. The presence of dizziness & nystagmus indicates that you’re probably suffering from vertigo. This test could also be done using cameras to monitor eye movements. It is then called the Video Head Impulse Test (vHIT).
• The ENG test, also called the Electronystagmography test, is a Vertigo test that utilizes electrodes fit around your head to check for any abnormal eye movements when the doctor moves your head in various directions. The reading of the electrodes is recorded via computers, which a doctor then checks to make an accurate diagnosis about your condition. A video version of the test, in which tiny cameras are placed around your head to record eye movements, is also widely used, & is called a videonystagmography test (VNG test).
• Walking tests, in which your doctor asks you to walk in a straight line with your eyes closed. They then check the degree of your deviation from the straight line to determine if you’re suffering from vertigo or not.

Other tests used to diagnose vertigo are the Subjective Visual Vertical (SVV) test, the CCG test (Cochleography), & the DVA test (Dynamic Visual Acuity).

In this article, we get deeper into the ENG or Electronystagmography test for Vertigo.

The ENG test for Vertigo

The Eletronystagmography test, or ENG test as it is commonly called, is a vertigo test that determines the functioning of your cranial nerves in relation to the movement of your eyes.  These two cranial nerves are called the vestibulocochlear nerve(also called the acoustic nerve), & the oculomotor nerve.  The acoustic nerve controls the body’s hearing & balance by connecting the brain & the inner ear.

The oculomotor nerve, on the other hand, forms a connection between the brain & the eye muscles. Your doctor will recommend an ENG test for you if you’ve been experiencing vertigo symptoms for quite some time, & need to get a vertigo test done.

There are three parts to a standard ENG test for Vertigo. These are:

• Caloric Test: In this, electrode patches are placed on each side of your eyes, including above & below them. With your head held fastly in position, your doctor will introduce warm & cold water/air into your ears. The electrodes fitted to your head record the movement of your eyes & the vestibulocochlear nerve to the external temperature changes.
• Oculomotor test: This test involves your eyes following a certain target while your doctor keeps your head still in place. The results of this test help your doctor understand how well your eyes function in a tracking movement.
• Positional Test: For this test, your doctor will either turn your head to one side quickly or to lie down & stand up very quickly. Your doctor will then measure how well your eyes respond to the external motion stimulus.

Depending on the results of your ENG test, your doctor will determine the next steps in your vertigo treatment strategy.