Electronystagmography (ENG)

If you’re having trouble with balance or dizziness, your doctor might suggest an Electronystagmography (ENG) test. This tool checks how well your inner ear works. It also helps find any neurological problems that might be causing your balance issues.

ENG measures special eye movements linked to balance. These movements are controlled by the vestibular system. Doctors use this test to find out what’s causing your balance problems. Then, they can create a treatment plan that works for you.

ENG is a safe way to check for balance disorders. It gives doctors important information about your inner ear’s health. This helps them figure out if other things might be causing your dizziness.

Understanding Electronystagmography (ENG)

Electronystagmography (ENG) is a test that checks how well the vestibular system works. This system is key for balance and knowing where we are in space. It looks at eye movements called nystagmus to find problems in the inner ear and brain. These problems might cause dizziness, vertigo, or trouble balancing.

What is Electronystagmography?

ENG is a test that doesn’t hurt and looks at eye movements. Electrodes are put around the eyes to catch nystagmus. These eye movements show if the vestibular system is out of balance.

How ENG Works

The ENG test checks different parts of the vestibular system:

The test records eye movements with special technology. Then, a specialist looks at the recordings to find any problems. By comparing each ear’s response, they can find where balance issues come from.

ENG is a detailed test that shows how the inner ear and brain work together. It helps doctors make plans to fix balance problems. This way, patients can feel better and live a better life.

Indications for ENG Testing

Electronystagmography (ENG) is a key tool for checking balance and inner ear health. It’s used when people have dizziness, vertigo, or imbalance. This test helps find the cause and suggests the right treatment.

Symptoms that Warrant an ENG Test

Some symptoms suggest you might need an ENG test. These include:

Conditions Diagnosed with ENG

ENG testing can spot many inner ear disorders and neurological conditions. It helps find issues like:

• Benign paroxysmal positional vertigo (BPPV)
• Meniere’s disease
• Vestibular neuritis or labyrinthitis
• Acoustic neuroma
• Multiple sclerosis
• Brain stem lesions or tumors

Knowing the exact cause of symptoms lets doctors create better treatment plans. This helps reduce dizziness, vertigo, and imbalance. It also improves a person’s life quality.

The ENG Procedure: What to Expect

When you have an ENG test, it usually takes about 60 to 90 minutes. First, electrodes are placed around your eyes. These small, sticky electrodes help measure your eye movements. They connect to a computer that records and analyzes your eye signals.

During the test, you’ll see different visual stimuli and do specific eye movements. You might follow a moving light with your eyes while keeping your head steady. The technician will also check how well you can keep your eyes fixed on a target and track moving objects smoothly.

The test also includes balance tasks to check your vestibular system. You might be asked to turn your head or tilt it while your eye movements are recorded. These tasks help see how well your vestibular system works with your eyes to stay stable.

The typical parts of an ENG test and their times are as follows:

A trained technician will guide you through the ENG procedure. They’ll give you instructions and make sure you’re comfortable. Even though the test is non-invasive, some people might feel a bit uncomfortable or dizzy. These feelings are usually short-lived and go away soon after the test ends.

Preparing for an ENG Test

Getting ready for an ENG test is key for good results and a comfy test. By following the pre-test steps and knowing what to wear and bring, patients can make the test go well.

Pre-test Instructions

Before the ENG test, you might need to stop some medications. Some drugs can mess with the test results. Tell your healthcare provider about all your meds, including over-the-counter ones and supplements. They’ll tell you which ones to skip and for how long.

Also, share your medical history with the provider. This includes any ear surgeries, head injuries, or neurological issues. This info helps the provider understand your ENG test results better.

What to Wear and Bring

On test day, wear comfortable clothing that’s easy to get to your neck and ears. Don’t wear makeup, like mascara, as it can mess with the electrodes. If you wear contact lenses, bring a case and solution to remove them before the test.

Here are some things to bring to the appointment:

By following these tips for ENG test preparation, you can make sure the test goes smoothly. This leads to a correct diagnosis and the right treatment for vestibular disorders.

Components of an ENG Test

An ENG test looks at different parts of the vestibular system and eye movements. It includes ocular motor testing, positional testing, and caloric stimulation. Each part helps find the cause of dizziness or vertigo.

Ocular Motor Testing

Ocular motor testing checks how well the eyes work. It looks at gaze stability, saccades, and tracking. The patient follows a moving target with their eyes while keeping their head steady.

The ENG records these eye movements. It looks for any problems, like:

Positional Testing

Positional testing checks for positional nystagmus. This is an abnormal eye movement in certain head positions. The patient lies down, and the examiner moves their head in different ways.

• Supine (lying on back)
• Right and left lateral (lying on sides)
• Head hanging (head tilted back)

The ENG looks for nystagmus in these positions. It can show problems with the vestibular system, like BPPV.

Caloric Stimulation

Caloric stimulation tests each inner ear separately. Warm and cool water or air is put in the ear canal. This stimulates the vestibular system and causes nystagmus.

The ENG records these eye movements. It compares the responses from each ear. If one ear doesn’t respond well, it might show a vestibular problem.

Interpreting ENG Results

After the ENG test, a specialist looks at the nystagmus patterns and other data. They check if the patient’s vestibular system is working right. Understanding normal and abnormal findings is key to diagnosing vestibular disorders.

Normal vs. Abnormal Findings

Healthy people usually have no issues with their eye movements during the test. But, those with vestibular disorders might show certain patterns or responses. These signs help find the cause of their symptoms.

Common Abnormalities and Their Implications

Some common issues found by ENG include:

• Unilateral vestibular weakness: This means one ear doesn’t respond well to tests, hinting at damage.
• Directional preponderance: This is when nystagmus is stronger in one direction, showing an imbalance.
• Positional nystagmus: This type is triggered by certain head positions, often linked to BPPV.
• Central nystagmus: This pattern suggests a brain or central vestibular issue, like a stroke or tumor.

By studying ENG results and the patient’s symptoms, specialists can pinpoint many vestibular disorders. This info is vital for creating a treatment plan that fits the patient’s needs.

Advantages of ENG over Other Vestibular Tests

Electronystagmography (ENG) is a top choice for checking the vestibular system. It looks at both the outer and inner parts of the balance system. This gives a full picture of how balance works and where problems might be.

ENG is also easy on patients because it’s non-invasive. It doesn’t need injections or surgery, unlike some other tests. This makes it comfortable for most people.

ENG is very good at finding balance problems. It tracks eye movements to spot even small issues. This is key for diagnosing things like vestibular neuritis and Meniere’s disease.

The following table compares the key advantages of ENG with other common vestibular tests:

In short, ENG is a great tool for doctors to check balance problems. It’s thorough, easy on patients, and very good at finding issues. This helps doctors give better care and improve patient results.

Risks and Side Effects of ENG Testing

Electronystagmography (ENG) is a safe and non-invasive test. Some people might feel side effects during or after it. These effects are usually mild and go away a few hours after the test.

The most common side effects include:

These side effects come from the caloric stimulation part of the test. This involves cool and warm air or water in the ear canals. It can cause brief vertigo, leading to dizziness, nausea, and disorientation.

To lessen these effects, patients should plan for a ride home after the test. Driving might be unsafe until symptoms go away. Sometimes, the doctor might suggest resting in the office before leaving.

It’s key to remember that serious problems from ENG testing are very rare. But, if you have severe or lasting side effects, tell your doctor. This could mean you need more checks or care.

Advancements in ENG Technology

Recent changes in electronystagmography (ENG) technology have changed how we do neuro-otological exams. These new tools help track eye movements better, leading to better diagnosis and treatment of balance problems. Two big steps forward are computerized ENG systems and video-oculography (VOG).

Computerized ENG Systems

Computerized ENG systems have become the new standard, replacing old analog devices. They offer clear recordings, easy setup, and the chance to keep and look at data online. These systems also do more detailed eye movement analysis, catching small issues that might be missed.

Video-Oculography (VOG)

Video-oculography (VOG) is a big leap in ENG tech. It uses video to track eye movements, beating traditional ENG in many ways. VOG lets us record eye movements in the dark, without electrodes, making it more comfortable for patients. It also gives a more accurate eye position reading, helping spot balance problems better.

As ENG tech keeps getting better, we can expect even more precise exams. Using digital systems and VOG, doctors can give better care to those with balance issues. This means better health outcomes and a better life for patients.