Videonystagmography (VNG): Vestibular Assessment

VNG is a test to evaluate the possible etiology of your dizziness. This test takes approximately 60 to 90 minutes. In most cases, VNG testing will allow us to determine potential causes of your symptoms and plan a course of treatment.

Description of the VNG Test:

During most of your VNG, you will wear a set of infrared goggles that will record the movement of your eyes. Parts of the test will take place in the dark with the goggles capped.

The Three Parts of the VNG Test:

  1. Ocular-Motor Evaluation: This part of the test evaluates your eye muscles and central nervous system. You will be asked to follow a red light moving vertically and horizontally at variable speeds.
  2. Positional Evaluation: This part of the test evaluates both your central nervous system and the balance organs of your inner ear. You will be asked to sit, lie down, and turn your head. Part of this test involves a rapid change in position from a sitting to lying down position and is modifiable, if necessary, due to back and or neck disorders.
  3. Caloric Evaluation: This part of the test evaluates the function of the balance organs of the inner ear. During the test, you will lie comfortably on your back while wearing the goggles. Cool and warm air will be introduced into each ear canal for approximately 2 minutes at a time. You will be allowed to rest for approximately 3 minutes between each portion of the evaluation.

It is important to remember that, while you may feel dizzy during the test, you should feel better by the time you leave. If you are concerned about the lasting effects of nausea, you are encouraged to bring a friend or family member with you to drive you home.

Important Things to Remember:

  1. Please wear comfortable clothing.
  2. Bring a case/solution if you wear contact lenses. Bring a case for your glasses and/or hearing aid(s).
  3. A co-pay may be charged for diagnostic testing in addition to the co-pay charged for the consultation with our doctors. This varies by insurance plan. If there is a second co-pay this will be due on the date of service.

Frequently Asked Questions

What should I expect on my first visit and how long are the examinations?


Dizziness or balance examinations will include evaluating the inner ear, eye movement and neurological connections that links them all together. You can expect to be here about 1 ½ hours to 2 hours should a hearing assessment be involved. Hearing evaluations can last about 1 hour.
What type of testing do you do, and will the examination be uncomfortable?


The testing is not painful, and our doctors will make sure you are comfortable during the evaluation. All testing is state of the art and computer based. Our doctors will perform a series of tests to determine the cause of your dizziness. Examination will include evaluating the inner ear, eye movement and neurological connection that links them all together.
Is it OK if I eat before my appointment?


To prevent nausea, avoid eating and drinking caffeine at least 4 hours prior to testing.

While it is okay to eat, please eat light, and avoid heavily fried foods or lots of dairy products. Although most people do just fine with the balance tests, some parts that might make you feel a little dizzy — so, to reduce any nausea you might otherwise experience, we ask you not to eat a heavy meal.

Is it OK if I leave my makeup on during my balance test?


No. Makeup, particularly eye makeup, face lotion, or sunscreen on the face the day of the test. These often disturb our sensitive equipment and prevents accurate results.

Lip balm and lipstick are allowed.

Should I take my dizziness medicine before the test?


We ask that you DO NOT take on the day of your appointment the following: these include but are not limited to Anti-vertigo medications such as Meclizine, and other strong sleeping pills and pain pills that can cause drowsiness, because these drugs can affect the results of testing.
Should I stop taking all my medications? No, not all medications need to be stopped. Please call us at 1-425-277-9521 if you have questions

CONTINUE taking medication for long-term conditions such as:

  • Diabetes
  • High blood pressure
  • Heart related conditions
  • Seizures
  • Thyroid problems
  • Steroids
  • Antibiotics.

STOP taking these medications for 48 hours prior to the exam:

  • Tranquilizers
  • Vestibular suppressants
  • Sleeping pills
  • Other types of central nervous system suppressants. Examples include, but are not limited to:
  1. Valium
  2. Meclizine
  3. Dramamine
  4. Bonine
  5. Any Antihistamines/Allergy Medications, Melatonin, Tylenol/Advil PM.
Can I drink alcohol or smoke weed before my exam? ·         No alcohol 48 hours prior to the exam.

·         No smoking or eating any form of weed, and this includes vaping or any other devices that introduce THC into the bloodstream

Will the examination make me feel dizzy?


Everybody’s reaction is different. It depends on what the underlying cause of your dizziness is. If you’re already dealing with dizziness symptoms, the tests won’t make them worse than they already are and they won’t cause previous dizziness episodes to return.  Our doctors will make sure they keep you as comfortable as possible.
Should I have someone bring me to my appointment for balance testing? Most of our patients feel just fine to drive after testing. However, if your present symptoms are severe, it’s not a bad idea to have someone drive you.
Are there after effects or side effects after a VNG? These may temporarily make you feel worse after a VNG test. Common after-effects of the test include: Headache, fatigue, minor earache, residual nausea and mild vertigo lasting a few hours.
What are the other possible complications from a VNG? While these complications have been reported in the literature, please remember these are extremely rare: Tympanic membrane perforation, anxiety, spinal injury, persistent vertigo/nausea, cardiac arrest.