By Attorney Gordon Johnson
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The ENG (Electronystagmography) is a complex test, used to identify pathology with respect to the vestibular system, the cranial nerves and the brain stem. It is perhaps the most sensitive test for identifying pathology for someone with a mild brain injury. This testing is sometimes also referred to as caloric testing, however, this testing has come to refer to a battery of eye movement tests, some of which require recording of nystagmus.
This test really should be interpreted and clinically correlated (to the head injury) by a neurootologist or otolaryngologist as it is a complex test, used to identify pathology with respect to the vestibular system, the cranial nerves and the brain stem. It is perhaps the most sensitive test for identifying pathology for someone with a mild brain injury.
The ENG includes a combination of tests, because there is no method of directly stimulating and recording vestibular disorders, without indirect measures. The ENG commonly includes the following testing:
These tests are most helpful if administered by a neurootologist or otolaryngologist, doctors who are highly specialized, the type of doctors you would typically find in a listing of ear, nose and throat specialists. Not all ENT's, however, are qualified to properly interpret the results of an ENG, especially if the underlying cause of the vertigo, dizziness or nausea, is trauma. As said in the American Academy of Neurology's Practice Parameter on the Use of ENG:
"The usefulness of electronystagmography testing is highly dependent upon both test administration and test interpretation. At this time, there is no agency that governs credentials for persons who administer electronystagmography testing. Such individuals are often professionals with training in allied fields, such as audiology, but also include persons with little, if any technical background."
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