When to Administer an ENG?

By Attorney Gordon Johnson

Call me at 800-992-9447

When is an ENG called for? According to the American Academy of Neurology's "Practice Parameter on the Use of ENG" the ENG should be considered:

"When the physician suspects a vestibular disorder, electronystagmography may provide useful information regarding reduced function in one or both ears or an inbalance between the two ears. Symptoms suggestive of a vestibular abnormality include vertigo, dizziness, and dysequilibrium."

The AAN, while clarifying that not all patients with complaints of dizziness or dysequlibrium require an ENG, it should be considered when one of the following are present:

• Meniere's Disease
  
• Vestibular Neuritis
  
• Recurrent Vestibulopathy
  
• Migraine associated dizziness
  
• Benign Paroxysmal Vertigo of Childhood
  
• Labyrinthe Ischemia
• Chemical Induced Vestibulotoxicity

In our experience, from a forensic standpoint in non-coma brain injury cases, this is perhaps the single most useful test. It provides what the defense will call "objective evidence" of abnormality, in the highest percentage of cases. In contrast to MRI and CT scans which are normal in the vast majority of Subtle© Brain Injury cases, the ENG is often abnormal. And while in persistant vertigo and dizziness cases, such abnormality may not necessarily point to a classical vestibular diagnosis, it will often indicate significant neuropathology in either the cranial nerves or the brainstem.

Contact Attorney Gordon Johnson: 1-800-992-9447

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