Vestibular and Neuro-Diagnostic Testing
The licensed and certified audiologists at ENT Consultants have received advanced training in the field of Audiology. They receive continuing education that allows them to provide patients with the most advanced neuro-diagnostic testing. The audiologists work closely with Dr. Robert L. Daniels, West Michigan’s only neurotologist.
To receive neuro-diagnostic testing, a physician must refer you to our office. During the initial assessment, the test ordered by the referring physician will be performed. Following the testing, a complete report will be sent to the referring physician.
Nearly forty percent of all people over the age of 40 experience dizziness or balance problems during their lifetime. There are many causes for dizziness. The Audiology Department at ENT Consultants specializes in vestibular diagnostic testing to determine the cause of your difficulties with balance. One or more of the following tests many be helpful in determining the best treatment for your dizziness: Electronystagmography (ENG), Electrocochleography (ECOG) or Vestibular Evoked Myogenic Potential (VEMP).
An ENG provides an objective measure of the vestibular (balance) system. During this test, eye movements will be recorded while different patterns of movement will be evaluated. The test consists of three sections: 1) Eye movements: The patient will watch a target light that is stationary or in motion. 2) Positionals: The audiologist will move the patient through various head and body positions, including the Dix Hallpike Maneuver. 3) Calorics: The ear will be warmed and cooled with 60 seconds of airflow into the ear canals.
Important ENG Testing Information
The morning of your scheduled test, please do not smoke, eat or drink caffeinated beverages such as coffee or tea at least two hours prior to the test. Please do not wear makeup or moisturizers the morning of your test. It is important that you do not take any of the following medications 48 hours prior to your test:
- Tranquilizers (Valium, Librium, Ativan…)
- Antihistamines (Benadryl, Atarax…)
- Medications for dizziness or motion sickness (Antivert, Scopolamine…)
- Alcoholic Beverages
- Sleep Aids
Do not discontinue medication for diabetes, thyroid, heart conditions, seizures or blood pressure management. If you are not sure whether or not to take a medication, please call our office. This testing may cause some patients to feel dizzy or unsteady. If possible, please arrange for a family member or friend to provide transportation.
An ECOG provides an objective measure of the electrical potentials generated in the inner ear as a result of sound simulation. This test is often used to determine if the inner ear (cochlea) has an excessive amount of fluid pressure which can cause symptoms of hearing loss, aural fullness, dizziness, and/or tinnitus. These symptoms are sometimes indicative of certain ear pathologies such as Meniere’s Disease or Endolymphatic Hydrops.
Vestibular Evoked Myogenic Potential (VEMP)
A VEMP is an objective test that identifies lesions of the saccule, the inferior vestibular nerve, and the descending vestibulospinal pathways. Electrodes are placed on the neck and forehead while insert earphones are placed in the ears to deliver a tone burst stimulus. The patient will lie down and be asked to lift his or her head during the procedure.
Neuro-Diagnostic testing has a wide range of clinical applications. The Audiology Department at ENT Consultants offers the following services to help provide physicians with more information regarding the status of your auditory nerve and peripheral system.
Auditory Brainstem Response (ABR)
An ABR is an objective test that can be used to stimulate hearing sensitivity and help identify neurological abnormalities of the auditory nerve and the auditory pathway through the brainstem. Electrodes are placed on the ear lobes and forehead while insert earphones are placed in the ears to deliver a click stimulus.
Otoacoustic Emissions (OAE’s)
An OAE is an objective test that is used to determine cochlear status, specifically outer hair cell function. Information can be used to:
- screen hearing
- test functional hearing loss
- differentiate between the sensory and neural components of sensorineural hearing loss
- monitor for medications toxic to the ear
- partial estimate hearing sensitivity within a limited range.