VNG (Advanced test for Vertigo)

Some dizziness symptoms should be treated as urgent because they may not be a simple inner-ear vertigo problem.

• Vertigo with weakness of one side, facial drooping, slurred speech or confusion
• Severe new headache, fainting, chest pain or repeated vomiting with dehydration
• Sudden hearing loss, severe ear pain, ear discharge or recent head injury
• New walking difficulty, double vision or dizziness that feels very different from previous episodes

Early evaluation helps identify serious or fast-changing ENT problems before they become harder to manage.

VNG means videonystagmography. In simple words, it is an advanced test for vertigo that records eye movements because the eyes and inner-ear balance system are closely connected.

When the balance system is disturbed, the eyes can show certain movement patterns. Studying those patterns can help the ENT doctor understand whether the dizziness may be coming from the inner ear or another balance pathway.

• Helps study eye movement and balance response
• Useful in selected patients with repeated or unclear vertigo
• May support a more targeted treatment plan
• Usually advised after doctor evaluation, not for every dizzy patient

VNG may be advised when symptoms suggest an inner-ear balance problem, but the exact pattern needs more clarity. The goal is to reduce guesswork and avoid treating all dizziness as the same condition.

• Repeated spinning attacks
• Unsteady walking or imbalance
• Vertigo with nausea
• Dizziness not clearly fitting BPPV
• Suspected one-sided balance weakness
• Vertigo with hearing or tinnitus clues

The reason for testing is always linked to the patient story. Some patients need only positional assessment and manoeuvre treatment, while others benefit from advanced testing.

• BPPV-like symptoms that are not straightforward
• Recurrent vertigo despite previous treatment
• Need to check whether one ear balance response is weaker
• Need for objective information before planning next steps

The doctor first reviews the vertigo pattern, triggers, duration, ear symptoms, hearing changes, medicines and safety concerns such as falls. VNG is then planned only when it is clinically useful.

• ENT examination and symptom history
• Eye movement recording during selected test steps
• Assessment of balance response under supervision
• Interpretation along with hearing, ear and positional findings

VNG helps guide treatment by showing whether the pattern supports inner-ear vertigo, one-sided balance weakness, positional vertigo or a need for another evaluation pathway.

• BPPV manoeuvre if positional vertigo is confirmed
• Medicines only when needed for nausea or acute symptoms
• Vestibular and balance guidance based on the pattern
• Further hearing or vertigo tests when the result suggests they are needed

The main value is a clearer plan. Patients should not feel that every vertigo complaint automatically needs advanced testing. The right test is chosen only when it helps decision-making.