A diagnostic test that uses infrared camera goggles to record eye movements while the vestibular system is stimulated. The most objective way to map which ear is causing vertigo.
Medical definition
Videonystagmography records nystagmus — the involuntary eye movements triggered by vestibular stimulation — using small cameras inside a pair of goggles worn by the patient. The test has three main components: oculomotor tests (smooth pursuit, saccades, optokinetic response), positional testing (Dix-Hallpike and supine roll), and caloric testing (warm and cool air or water irrigated into each ear canal to stimulate each labyrinth independently). Together these components let the clinician map the entire vestibular system and identify which side is affected and how severely.
Why it matters for vertigo
Bedside examination gives a rough picture. VNG gives a precise one. The caloric test, for example, can measure a 25% weakness in one ear versus the other — a level of asymmetry that is impossible to detect just by watching a patient’s eyes in a lit room. For conditions like vestibular neuritis, Meniere’s disease, and bilateral vestibulopathy, this data directly changes management. Without it, treatment decisions are educated guesses.
Where I see this in clinic
Prime ENT Center in Hardoi is the only facility in Central Uttar Pradesh with full VNG capability. I use it routinely for patients with recurrent vertigo, suspected Meniere’s, failure to respond to standard BPPV maneuvers, and any case where the side of lesion is unclear. The test takes about 45 to 60 minutes. Patients are asked to stop anti-vertigo medications 48 hours before and avoid alcohol and a heavy meal on the day. Results are available the same session and inform the treatment plan directly.
Related terms
Nystagmus — the eye movement VNG records. Dix-Hallpike test — one component of the VNG positional battery. Cupulolithiasis — a BPPV variant that shows a specific VNG pattern. Canalithiasis — the more common BPPV mechanism, also identifiable on VNG.
Medical Disclaimer: This glossary entry is for educational purposes only and is not a substitute for in-person clinical assessment. For a diagnosis and management plan, consult Dr. Prateek Porwal directly. WhatsApp: 7393062200.