Dizziness Depot

Bell’s Phenomenon Sometimes the competition isn’t even close. Think Germany versus Brazil in the World Cup. For those of you that have been doing ENG exams for years, back when electrode based testing was the norm. Do you remember how every time you would ask the patient to close their eyes, you would have to re-center the tracing because the

ENG Versus VNG: Which Is Better? Artifact Artifact affects both ENG and VNG recordings, but not from the same source. With ENG (electronystagmography), the recording is subject to contamination from ambient muscle electrical activity and artifact associated with eye blinks. Eye blinks can occur with the eyes open or closed. Many patients exhibit activity in the vertical channel whenever their

Potential Calibration Errors As a reminder, Electronystagmogaphy (ENG) is based on recording changes in the corneoretinal potential, with these changes assumed to correspond to eye movements. However, there are other factors that cause a change in corneoretinal potential, putting test accuracy at risk. First, you cannot start your exam as soon as the patient is registered and the electrodes applied.

Videonystagmography This week, I am using an excerpt from my book, Vestibular Function: Clinical and Practice Management (Thieme, 2011) to describe the process involved in Videonystagmography. Infrared Video (as used in VNG) involves the use of a conventional black and white video camera; however, the eyes are illuminated with infrared light. Because the eyes are not reactive to infrared light,

Electronystagmography or Videonystagmography: Which is better? The term electronystagmography (electrical graph of nystagmus) has been used to describe a series of vestibular tests using an eye movement recording technique known as electro-oculography (EOG).* This refers to the recording of the electrical potentials associated with eye movements. The principle behind EOG is the recording of changes in the corneoretinal potential through

Last week we discussed the benefits and advantages of the ENG/VNG exam over other testing techniques. This week, we discuss the limitations associated with this test, which include: (1) The inability to record (except visually) torsional or rotary eye movements common in benign paroxysmal positional vertigo (BPPV): With ENG we were limited to recording in just the X-Y axis, up

Useful, but Limited Videonystagmography (VNG), or Electronystagmography (ENG), is the most common method of vestibular evaluation and is available in many Audiology and ENT offices. A VNG or ENG examination is not a comprehensive vestibular or balance assessment, but is often described as such on clinic websites. The VNG/ENG exam is one component of a comprehensive evaluation, but many vestibular

The Natural Progression of the Hard of Hearing: A Personal Story This week I am taking a departure from my regular topics related to dizziness, vertigo and vestibular function. In addition to being an audiologist, I am also a member of the hearing impaired public. My three years spent working in a very loud campus pub during college cost me

Cpt Code 92544 and CPT Code 92545 This week we wrap up our descriptions of the components of the Videonystagmography examination with the oculomotor tests.* Since the preparation and procedures are so similar, I will cover both optokinetic tracking and smooth pursuit (oscillating) tracking in the same blog, but will delete repetitive sections. CPT Code 92544 – Optokinetic nystagmus test,

CPT Code 92543 -Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes 4 tests), with recording Goggles with cameras illuminated by infra-red lighting are placed on the patient. The darkest spot of the eye, the pupil, is tracked by the software, so a tracking threshold must be established. Once tracking is established, a calibration procedure begins in which the patient is