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Electronystagmography
ENG
Electronystagmography is a test that looks at eye movements to see how well two nerves in the brain are working. These nerves are:
- Vestibular nerve (8 th cranial nerve), which runs from the brain to the ears
- Occulomotor nerve, which runs from the brain to the eyes
How the Test is Performed
Patches called electrodes are placed above, below, and on each side of your eyes. They may be sticky patches or attached to a headband. Another patch is attached to the forehead.
The health care provider will spray cold water or air into each ear canal at separate times. The patches record eye movements that occur when the inner ear and nearby nerves are stimulated by the water or air. When cold water enters the ear, you should have rapid, side-to-side eye movements called nystagmus.
Next, warm water or air is placed into the ear. The eyes should now move rapidly toward the warm water then slowly away.
You may also be asked to use your eyes to track objects, such as flashing lights or moving lines.
The test takes about 90 minutes.
How to Prepare for the Test
Most of the time you do not need to take special steps before this test.
- Your health care provider will tell you if you need to stop taking any medicines before you have this test.
- DO NOT stop or change your medicines without talking to your provider first.
How the Test will Feel
You may find cold water in the ear slightly uncomfortable. Brief dizziness (vertigo) may occur during the test.
Why the Test is Performed
The test is used to determine whether a balance or nerve disorder is the cause of dizziness or vertigo.
You may have this test if you have:
- Dizziness or vertigo
- Hearing loss
- Possible damage to the inner ear from certain medicines
Normal Results
Certain eye movements should occur after the warm or cold water or air is placed into your ears.
Note: Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.
What Abnormal Results Mean
Abnormal results may be a sign of damage to the nerve of the inner ear or other parts of the brain that control eye movements.
Any disease or injury that damages the acoustic nerve can cause vertigo. This may include:
-
Blood vessel disorders with bleeding (hemorrhage), clots, or
atherosclerosis
of the blood supply of the ear
Atherosclerosis
Hardening of the arteries, also called atherosclerosis, occurs when fat, cholesterol, and other substances build up in the walls of arteries. These ...
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Cholesteatoma
and other
ear tumors
Cholesteatoma
Cholesteatoma is a type of skin cyst that is located in the middle ear and mastoid bone in the skull.
Read Article Now Book Mark ArticleEar tumors
Benign ear cysts are lumps or growths in the ear. They are benign.
Read Article Now Book Mark Article - Congenital disorders
- Injury
- Medicines that are toxic to the ear nerves, including aminoglycoside antibiotics, some antimalarial drugs, loop diuretics, and salicylates
- Multiple sclerosis
- Movement disorders such as progressive supranuclear palsy
-
Rubella
Rubella
Rubella, also known as the German measles, is an infection in which there is a rash on the skin. Congenital rubella is when a pregnant woman with rub...
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Additional conditions under which the test may be performed:
-
Acoustic neuroma
Acoustic neuroma
An acoustic neuroma is a slow-growing tumor of the nerve that connects the ear to the brain. This nerve is called the vestibular cochlear nerve. It...
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Benign positional vertigo
Benign positional vertigo
Benign positional vertigo is the most common type of vertigo. Vertigo is the feeling that you are spinning or that everything is spinning around you...
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Labyrinthitis
Labyrinthitis
Labyrinthitis is irritation and swelling of the inner ear. It can cause vertigo and hearing loss.
Read Article Now Book Mark Article -
Meniere disease
Meniere disease
Ménière disease is an inner ear disorder that affects balance and hearing.
Read Article Now Book Mark Article
Risks
Rarely, too much water pressure inside the ear can injure your ear drum if there has been previous damage. The water part of this test should not be done if your eardrum has been perforated recently.
Considerations
Electronystagmography is very useful because it can record movements behind closed eyelids or with the head in many positions.
References
Griggs RC, Jozefowicz RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 396.
Kerber KA, Baloh RW. Neuro-otology: l diagnosis and management of neuro-otological disorders. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice . 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 37.
Review Date: 6/1/2015
Reviewed By: Daniel Kantor, MD, Kantor Neurology, Coconut Creek, FL and immediate past president of the Florida Society of Neurology (FSN). Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
