Are videonystagmography (VNG) signs useful for diagnosing concussion?

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Last updated: May 4, 2025View editorial policy

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From the Guidelines

Video signs can be a useful adjunct in concussion diagnosis, particularly when combined with clinical evaluation, symptom assessment, and neurocognitive testing, as they provide objective evidence of the injury mechanism and immediate responses. The use of video analysis in concussion diagnosis is supported by the fact that it allows medical professionals to observe the mechanism of injury, immediate responses, and visible signs that might indicate a concussion, such as loss of consciousness, impact seizures, motor incoordination, and blank or vacant stares 1. However, it is essential to note that video signs should not be relied upon exclusively, as many concussion symptoms are not visible on video, including headache, dizziness, and cognitive difficulties.

The importance of a comprehensive assessment approach in concussion diagnosis is highlighted by the American Academy of Pediatrics, which emphasizes the need for a clear understanding of the definition, signs, and symptoms of concussion to recognize it and rule out more severe intracranial injury 1. Additionally, a systematic review and meta-analysis published in JAMA Network Open in 2021 underscores the complexity of concussion diagnosis and management, particularly in cases of persistent postconcussion symptoms, and the need for a multifaceted approach that incorporates various nonpharmacological interventions 1.

Key points to consider when using video signs in concussion diagnosis include:

  • The mechanism of injury and immediate responses can provide valuable information about the potential for concussion
  • Visible signs such as loss of consciousness, impact seizures, and motor incoordination can indicate a concussion
  • Video review is particularly useful in sports settings where injuries can be captured from multiple angles
  • Video assessment should always be combined with clinical evaluation, symptom assessment, and neurocognitive testing for accurate diagnosis
  • Many concussion symptoms are not visible on video and require a comprehensive assessment approach for detection.

From the Research

Concussion Diagnosis and Management

The provided studies do not specifically mention the use of videos as a tool for concussion diagnosis. However, they do discuss various approaches to diagnosing and managing concussion, including:

  • Standardized clinical tools for assessment 2
  • A structured method for diagnosis, including history, physical examination, and additional tests 3
  • Evaluation and management of concussion, including treatment of common symptoms [(4,5)]
  • Therapeutic interventions, such as exercise, rehabilitation, rest, and return to activity protocols 6

Use of Videos in Concussion Diagnosis

There is no direct evidence in the provided studies to support the use of videos as a tool for concussion diagnosis. The studies focus on clinical tools, physical examinations, and therapeutic interventions, but do not mention videos as a diagnostic aid.

Limitations and Future Research

The studies highlight the need for further research on concussion diagnosis and management, including the development of evidence-based guidelines and therapeutic interventions [(2,3,5,6)]. However, they do not suggest that videos are a potential area of research for concussion diagnosis.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Diagnosis and Management of Acute Concussion.

Physical medicine and rehabilitation clinics of North America, 2017

Research

Concussion: Evaluation and management.

Cleveland Clinic journal of medicine, 2017

Research

Concussion Evaluation and Management.

The Medical clinics of North America, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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