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Neurotological Evaluation


The balance system of our body is maintained by inputs from the eyes, inner ears and proprioceptive system. These three systems send signals to the brain for proper co-ordination and maintenance of balance. A neurotological evaluation encompasses an evaluation of functioning and co-ordination of these systems. Any disturbance in the harmonious functioning of these systems is diagnosed by our neurotological team.

The clinical tests which are done for evaluation of the balance or vestibularsystem include

  • Video Frenzel for evaluation vestibulo-ocular reflex – spontaneous, pendulum, saccades, gaze induced nystagmus, head impulse test ,head shaking test

    View Demo 1

    View Demo 2

  • Electronystagmography (ENG) - This is an investigation to evaluate the vestibulo ocular reflex (VOR) which is involved in maintenance of balance. Recording of the following tests are done to evaluate peripheral and central vestibular function:
    • Spontaneous nystagmus
    • Gaze evoked nystagmus
    • Saccades
    • Pendulum test
    • Optokinetic stimulation
    • Caloric stimulation
    • Fistula test
  • Craniocorpography with SLR camera - This is a test is evaluate the vestibulospinal reflex which is responsible for maintenance of balance during motion. We do various tests including:
    • Romberg test
    • Sharpened Romberg test
    • Tandem walking
    • Unterburger’s test - Pictorial reports are given to the patient. In Unterburger’s test, the following points are evaluated:
      • Displacement
      • Sway
      • Angle of deviation
      • Body axis spin
  • Subjective visual vertical (SVV) and subjective visual horizontal (SVH) - This is a test is evaluate the otolith system which is responsible for deciding the vertically and horizontality of the viewed object. The static and dynamic SVV and SVH are important to:
    • Differentiate peripheral from central vestibular disorders
    • To decide side of peripheral vestibular insult
    • To diagnose compensated vestibular disorders
    • In follow up of vertigo patients to assess improvement

SVV Dynamic counterclockwise

  • Evaluation of center of balance and maintenance of posture