When is electronystagmography (ENG) indicated?

Updated: Aug 06, 2019
  • Author: Angela G Shoup, PhD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Although ENG is the most widely used clinical laboratory test to assess vestibular function, normal ENG test results do not necessarily mean that a patient has typical vestibular function. ENG abnormalities can be useful in the diagnosis and localization of site of a lesion. However, many abnormalities are nonlocalizing; therefore, the clinical history and otologic examination of the patient are vital in formulating a diagnosis and treatment plan for a patient who presents with dizziness or vertigo.

Although ENG testing cannot be used to determine the specific site of lesion, the information acquired can be integrated with history, symptoms, and other test results to aid in diagnosis. Comparing results obtained from various subtests of an ENG evaluation assists in determining whether a disorder is central or peripheral. In peripheral vestibular disorders, the side of lesion can be inferred from the results of caloric stimulation and, to some degree, from positional findings. An ENG evaluation can also be useful in ruling out potential causes of dizziness.

In a large study of patients tested with ENG in a wide range of clinical settings, Stockwell [4] found abnormal test results in approximately 39% of patients tested, and only about 29% of test results revealed the site of lesion. Peripheral vestibular abnormalities were found in approximately 23%, whereas central abnormalities were found in only approximately 5% of patients tested.

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