Bedside vestibular test with infrared videonystagmography (VNG)

By Cristiano Antonino On Jan 21, 2023

Infrared videonystagmography, which studies eye movements, is a key test for assessing patients with vertigo

Infrared videonystagmography, the evaluation of the vertigo patient

The assessment of the vertigo patient is closely linked to the collection of clinical information (anamnesis) and the ‘bedside’ test, i.e. the evaluation of the patient on the examination couch.

About 90 per cent of vertigo patients obtain an accurate diagnosis, or at least diagnostic guidance, from these two fundamental moments.

In the ear is the posterior vestibule, which is responsible for detecting movement and maintaining static and dynamic balance.

Eye movement is the monitor of vertigo.

The vestibologist during a vertiginous crisis studies the ear by looking the patient in the eyes!

In fact, when one or both vestibules are affected, an involuntary movement of the eyes, nystagmus, appears, giving the illusion of movement of the surroundings.

A key test is infrared videonystagmoscopy

Videonystagmography is a test that allows eye movements to be seen by the patient, who wears an obscuring mask to inhibit visual fixation, which has the effect of reducing nystagmus.

An infrared camera frames the eyes and their movement either spontaneously (spontaneous nystagmus) or caused by specific manoeuvres performed on the patient’s couch by the examiner.

By observing the direction of the nystagmus, also in relation to the movements the patient is made to perform, it is very often possible to make a very accurate diagnosis or to schedule second-level examinations such as VEMP’s (myogenic vestibular evoked potentials), vestibular caloric tests or a possible MRI.

The nystagmus detected by the infrared camera is recorded on a computer for later observation or for clinical studies on temporal parameters (speed, amplitude, direction, etc).

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