From the Guidelines
Electronystagmography (ENG) is a crucial diagnostic test for evaluating vestibular function and balance disorders, particularly in conditions like Ménière's disease, as recommended in the 2020 clinical practice guideline 1. The test is used to assess the vestibular system, which includes the inner ear and vestibular pathways in the brain, and is dedicated to balance, coordination, and maintenance of posture 1. Key aspects of ENG testing include:
- Caloric testing, where warm or cool air/water is introduced into the ear canal
- Positional testing
- Tracking tests The procedure typically takes 60-90 minutes and requires patients to avoid certain medications and substances beforehand, such as antihistamines, sedatives, anti-vertigo medications, alcohol, caffeine, and tobacco 1. ENG helps diagnose various conditions, including:
- Benign paroxysmal positional vertigo (BPPV)
- Ménière's disease
- Vestibular neuritis
- Other causes of dizziness or balance problems The test works by placing electrodes around the eyes to record eye movements, which can indicate vestibular dysfunction due to the connection between the vestibular system and the muscles controlling eye movements 1. While generally safe, patients may experience temporary dizziness or nausea during testing, as noted in the 2020 guideline 1.
From the Research
Electro Nystagmography
- Electro nystagmography (ENG) is a procedure used to evaluate patients with vertigo, as stated in the study 2.
- It records eye movements in response to numerous test maneuvers, including the bithermal caloric test, which uses air irrigations of the ears at different temperatures 3.
- The findings from ENG can be used to diagnose vertigo of various origins, including peripheral and central vestibular disorders 3.
Comparison with Videonystagmography
- Videonystagmography (VNG) is similar to ENG in the data obtained, but uses infrared cameras to monitor eye position 2.
- A study comparing ENG and VNG found that VNG is more valuable in assessing vertigo and discriminating between peripheral and central vestibular lesions 3.
- However, both ENG and VNG can be used to identify significant canal paresis, an important sign of peripheral vestibular lesions 3.
Clinical Applications
- ENG can be used to evaluate patients with vestibular disorders, including benign paroxysmal positional vertigo, vestibular neuritis, and Meniere's disease 4.
- The results of ENG can be used to guide treatment, such as canalith repositioning procedures or vestibular suppressant medications 4.
- ENG can also be used to monitor the effectiveness of treatment and to assess the progression of vestibular disorders over time 5.