Role of electronystagmography as a definitive tool in evaluation of vertigo: a clinical study

C. B. Nandyal, Ramchandra .


Background: Vertigo is one of the most distressing symptoms. It is difficult to identify, practically impossible to measure and not easy to treat. Electronystagmography (ENG) objectively records eye movements and thus tests the functional integrity of vestibulo-ocular reflex and its connections from inner ear to the brain. Hence, this present study was taken to evaluate the role of ENG in the diagnosis of vertigo, to know the peripheral, central and other causes of vertigo and to know the side of lesion. The aim of this study was to evaluate the role of ENG in the diagnosis of vertigo, to know the peripheral, central and other causes of vertigo and to know the side of lesion.

Methods: This study included 60 patients who presented with primary complaints of vertigo or dizziness. Patients were subjected to ENG under optimal conditions and the results were obtained in the form of a graphical recordings after analysis of the ENG data.

Results: Of the 60 patients subjected to ENG, a peripheral cause was seen in 33 patients. 21 patients were diagnosed with benign positional paroxysmal vertigo (BPPV), whereas 06 patients showed a central lesion of the vestibular system.

Conclusions: ENG acts as a useful screening tool to differentiate between peripheral cause of vertigo and central cause of vertigo. It has special significance in localizing the side of the lesion. Hence, ENG has proven to be a useful first line investigation in the diagnosis of vertigo.


Electronystagmography, Peripheral vertigo, Central vertigo

Full Text:



Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE Jr, Wehlre PA, et al. Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. Ann Intern Med. 1992;117(11):898-904.

Nazareth I, Yardley L, Qwen N, Luxon R. Outcomes of symptoms of dizziness in general practice community sample. Fam Pract. 1999;16(60:616-8.

Hanley K, O‘Dowd T, Considine N. A systematic review of vertigo in primary Care. Br J Gen Pract. 2001;51(469):666-71.

Herr RD, Zun L, Mathews JJ. A directed approach to the dizzy patient. Ann Emerg Med. 1989;18(6):664-72.

Jacobson GP, Mccaslin DL, Piker EG, Gruenwald J. Insensitivity of the "Romberg test of standing balance on firm and compliant support surfaces" to the results of caloric and VEMP tests. Ear Hear. 2011;32(6):1-5.

Bonanni M, Newton R. Test-retest reliability of the Fukuda Stepping Test. Physiother Res Int. 1998;3(1):58-68.

Rudert, H, Reker, U. The diagnostic value of the stepping test of Unterberger. HNO. 1977;25(7):246-8.

Hickey SA, Ford GR, Buckley JG, Fitzegerald AF. Unterberger stepping test: a useful indicator of peripheral vestibular dysfunction? J Laryngol Otol. 1990;104(8):599-602.

Cohen HS, Mulavara AP, Sangi-haghpeykar H, Peters BT, Bloomberg JJ. Screening people in the waiting room for vestibular impairments. South Med J. 2014;107(9):549-53.

Sharma V, Shah RK. Conventional vestibular function tests vs butterfly vestibulometry in peripheral vertigo. Nepal J Med Sci. 2014;3(1):31-7.

Kamath MP, Shenoy SV, Sreedharan S, Bhojwani K, Mammen SS, Majeed NA. Role of electronystagmography in balance disorders. Indian J Otol. 2015;21(3):201-8.

Gupta SK, Mundra RK. Electronystagmography a very useful diagnostic tool in cases of vertigo. Indian J Otolaryngol Head Neck. 2015;67(4):370-4.