Videonystagmography (VNG) for evaluation of vestibulo-ocular reflex.
The tests include evaluation of spontaneous nystagmus, smooth pursuit system, saccades, gaze-induced nystagmus, head shaking-induced nystagmus, test for skew deviation, nystagmus induced by hyper ventilation and optokinetic stimulation, Valsalva, caloric testing, and positional testing.
This is an investigation to assess the vestibulo-ocular reflex (VOR), which helps maintain the body's balance.
The following tests are recorded to assess peripheral and central vestibular functions of the human body:
- Spontaneous nystagmus
- Gaze-evoked nystagmus
- Smooth pursuit test
- Optokinetic stimulation
- Caloric stimulation
- Fistula test
Craniocorpography(CCG) to evaluate the vestibulospinal reflex, which is responsible for maintenance of balance during gait testing.
Evaluation is done by recording:
- Romberg test
- Sharpened Romberg test
- Tandem walking
- Unterburger’s test: in this test the following points are evaluated with pictorial reports given to the patient:
- - Displacement
- - Sway
- - Angle of deviation
- - Body axis spin.
Subjective visual vertical test (SVV) is conducted to determine a patient's ability to perceive the verticality of a viewed object (dependent on inputs
from visual, vestibular and somatosensory systems along with a functioning central nervous system) and to detect abnormal subjective tilt. At Dr Anita Bhandari's Vertigo and Ear Clinic both static and dynamic SVV are carried out to
- Differentiate peripheral from central vestibular disorders
- Decide side of peripheral vestibular insult
- Diagnose compensated vestibular disorders
- Evaluate patients of chronic dizziness
- Do follow up of vertigo patients to assess improvement.
Dynamic Visual Acuity (DVA) Test evaluates the ability of the patient to focus on moving images
and to stabilize images on the retina during head movement. The DVA test helps to diagnose vestibulotoxicity and VOR dysfunction.
Evaluation of centre of balance and maintenance of posture.
Diagnosis of the underlining cause of vertigo requires a battery of tests and, usually, a multidisciplinary approach by a panel of ENT, neurologist and psychiatrist.
─ Dr Anita Bhandari on using Virtual Reality (VR) technology for delivering customized vestibular rehabilitation packages to patients thousands of miles away.