Balance is a strange thing. When you can properly maintain your balance, you probably hardly ever think about it. If you feel dizzy or unstable, though, balance can be impossible to ignore. Insider your ear, neck, eyes and brain, a complex series of nerves help you maintain balance. When there is a problem inside this system, you literally feel like the world is shaking. Fortunately, you don’t have to put up with vertigo, dizziness, spinning or imbalance. Following Videonystagmographic testing, your doctor may have the information he or she needs to treat your condition. In this article, we tell you everything you need to know about a VNG test.

What Is a VNG Test?

Modern physicians use VNG testing to measure the inner ear and central motor functions. In fact, this technology has become the industry standard, surpassing other types of tests. When you submit for a VNG test, infrared cameras measure the movements of your eyes. Test results are usually accurate and consistent. Moreover, the VNG test is usually less invasive and more comfortable for patients than other types of ear and eye tests.

While professionals often refer to VNG testing as one procedure, it is usually a series of tests. The process documents a patient’s ability to maintain eye contact with an object. It also gauges whether an individual’s eyes are responding to his or her inner-ear signals.

What Does VNG Testing Measure?

Individuals who have good balance and no dizziness have a healthy vestibular system. That is, balance involves a good working relationship between the inner-ear and eye. Doctors use a VNG test to diagnose vestibular disease. In lay terms, a vestibular disease is an inner-ear disease. The test measures whether an inner-ear condition may be causing you to feel dizzy, unbalanced, unsteady or nauseated. Unlike many other tests, VNG testing identifies whether the problem is in both ears or isolated to just one.

Why Do Doctors Perform VNG Testing?

Vertigo, lightheadedness, dizziness, and nausea can have a variety of causes. Often, these conditions follow concussions, migraines, and traumatic brain injuries. Other times, they seemingly occur with no cause whatsoever. Doctors use VNG testing and other procedures to help identify the source of imbalance and dizziness. Since living with these conditions can be unbearable, many patients take comfort in either diagnosing or ruling out vestibular problems.

How Is a VNG Test Conducted?


Patients undergo VNG testing under the supervision of a doctor or technician. Because medical professionals must understand a patient’s eye movement, the subject wears infrared goggles. These goggles record eye movements throughout the test. While the test is generally painless, some patients express slight discomfort due to the pressure of the infrared goggles.

In most medical offices, VNG testing involves four separate stages. To help you better understand how your doctor will perform your VNG test, we discuss each stage individually.

Stage 1: Caloric Testing


For your inner-ear system to function properly, it must respond to stimulation. Since your eyes and your ears are connected, doctors can watch eye movement to know if your inner-ear reacts. With this part of the VNG test, the doctor or technician uses warm and cold air to stimulate your inner ear. Some clinics use warm and cool water instead of air. Simultaneously, the infrared goggles on your face measure eye movement. If your eyes react, your ear is responding to the air stimulation. If they don’t, you may have a problem with your inner-ear system. Expect the doctor or technician to perform this stage of the test on both your right and left ear for a complete picture of inner-ear functionality.

Having air or water in your ear can cause discomfort. In fact, most patients experience dizziness, vertigo or nausea while undergoing caloric testing. Fortunately, these sensations usually subside when this part of the test is complete. Nonetheless, if you find the test to be too unpleasant, your technician may have ways to mitigate dizziness.

Stage 2: Ocular Mobility Testing


To test ocular mobility, your doctor must see how your eyes move. When looking through infrared goggles, your doctor asks you to follow objects with your eyes. These objects move around in your field of vision. Some movements are smooth, while others are jerky. To complete this part of the test, you must relax and let your eyes move naturally. If you have difficulty following objects with your eyes, your doctor may diagnose a neurological disorder. Alternatively, your physician may decide you have an issue with your inner-ear system. Because your eyes are rapidly following light during this part of the test, you may feel dizzy. This is a normal sensation.

Stage 3: Optokinetic Nystagmus Testing


With ocular mobility testing, you are watching small objects move across your visual field. Optokinetic nystagmus testing asks you to watch a large object as it moves around. For accurate results, be sure you carefully track the object. If your eyes respond slowly or inaccurately, your doctor may conduct further tests of your inner-ear system. Even though you aren’t following many objects, you may feel a sense of vertigo or dizziness during this part of the test. Again, this is normal. It may, however, feel uncomfortable.

Stage 4: Positional Nystagmus Testing


The final phase of your VNG testing address positional nystagmus. For this part of the exam, you must move your head and body. The technician or doctor will instruct you how to move, while the infrared goggles measure eye movement. Expect to move in several different ways and to stand still. Also, plan to stand on different surfaces during this part of the test. If you have difficulty maintaining your balance, you may have problems with the endolymph fluid inside your ears. Because you are moving, you may lose your balance while undergoing positional nystagmus testing. Fortunately, the technician or doctor understand balance difficulties and take steps to protect you from injury.

Not all medical offices and imaging centers perform VNG testing the same. Some healthcare providers may separate the test into two or three stages. Nonetheless, all test results measure functionality through these four areas. If your doctor orders a VNG test, you can expect the test to essentially follow a similar procedure.

How Long Does a VNG Test Take?

Busy individuals often worry that testing and other medical procedures will cut into their everyday activities. Generally, that isn’t the case with a VNG test. In fact, the entire test is usually complete in under two hours. Because different clinics and medical offices use a variety of procedures, test length can vary. Before scheduling your VNG test, ask for a time estimate to be certain you budget enough time to comfortably complete the process.

How Do Doctors Use VNG Test Results?


VNG test results tell your doctor if you have a problem with your inner ear. After consulting results from all stages of the test, your doctor may make a diagnosis. Alternatively, he or she may order additional testing. Since the VNG test is accurate, it is often an easy way to rule out inner-ear conditions. Of course, if test results are inconclusive, your doctor may ask you to resubmit for VNG testing. This is usually rare.

How Do Individuals Prepare for VNG Testing?

Your doctor will likely give you a set of instructions to follow before your VNG test. It is important that you not deviate from these. Instead, to get accurate results, be sure you follow all instructions to the letter. Generally, patients must not take certain medications that may interfere with the test. Specifically, avoiding vestibular suppressants is often important. You probably also don’t want to take antihistamines and decongestants within 48 hours of your appointment.

Your doctor may want you to limit food consumption before your test. You may also need to wait to put in your contact lenses or wear eye makeup until the conclusion of the test. Again, your doctor will likely give you precise instructions on how to prepare for your VNG testing. Any pre-testing sacrifices you must make are worth it, as properly preparing yourself for the procedure boosts your odds of receiving accurate results and a reliable diagnosis.

Does Insurance Cover VNG Testing?

Most insurance plans cover VNG testing. Since insurance coverage varies from patient to patient, though, you should check with your provider before scheduling your VNG test. If your carrier does not cover a necessary VNG test, talk to your physician about alternatives. Occasionally, healthcare providers can convince insurance companies to cover tests that are otherwise outside of a patient’s policy.

Final Thoughts on VNG Testing

Nobody wants to live with vertigo, dizziness, imbalance or other problems related to the inner ear. With VNG testing, you don’t have to put up with discomfort and disorientation. This modern, effective examination gives doctors a ready way to diagnose inner-ear conditions. Because the procedure uses state-of-the-art technology, it is minimally invasive. It is also effective.

We hope we have answered all your questions about VNG testing. Simply put, if you have trouble with dizziness or balance, undergoing VNG testing may give you the answers you need to remedy the situation.

Featured Image via Depositphotos

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