ENG- AN IMPORTANT TOOL IN DIAGNOSING AND EVALUATING VERTIGO RELATED CONDITIONS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 17
Abstract
BACKGROUND The symptom of vertigo or dizziness is a common complaint, for which patient seeks neuro-otological consultation. The incidence is reported to be 20% - 30%, increasing with the age. ENG is used to determine the origin of various disorders that affect the hearing and vision problems. It is a diagnostic test to record involuntary movements of the eye caused by a condition known as nystagmus. It can also be used to diagnose the cause of vertigo, dizziness or balance dysfunction by testing the vestibular system. Aims and Objectives- To decide the role of ENG in diagnosis of patients complaining of dizziness. To determine the localising value of spontaneous nystagmus, gaze nystagmus and positional nystagmus, i.e. whether they help in differentiating central from peripheral and right from left sided lesion. To determine the reliability and sensitivity of culmination frequency and maximum slow phase velocity as a parameter in qualitative analysis of nystagmus. MATERIALS AND METHODS This included 30 patients coming to OPD with primary complaints of balance disorders (vertigo or dizziness) between the age group of 15 - 60 years. Patients underwent thorough clinical examination. PTA and ENG were done under optimal conditions. Results were obtained in the form of butterfly chart after analysis of ENG data. RESULTS Of the 30 patients, 23 patients were found to have peripheral vestibular lesion and 7 patients were found to have central lesion. True vertigo was diagnosed in 7 patients among patients of study group. 17 patients presented with vertigo along with mild-tosevere SNHL. 4 patients were concluded to have Meniere’s disease. Labyrinthitis due to trauma was found in 1 patient, while druginduced ototoxicity was found in 5 patients. 7 patients were diagnosed to have central pathology and 2 patients had vertebrobasilar insufficiency. Peripheral vestibular lesions are more common, partly due to their severity of presentation and also to the ease of diagnosis on clinical testing. Caloric tests are an integral part of peripheral vestibular testing. Electronystagmography has been a vital tool in the evaluation of vestibular pathology. Culmination frequency and maximum slow phase velocity are useful parameters in qualitative analysis of nystagmus. The new test available is videonystagmography, where the patient is given a helmet to wear with all sensors and light bars embedded in it. CONCLUSION Nystagmus which sometimes cannot be observed and nystagmus behind closed eyes can be recorded by ENG. No significant relationship between side of lesion and directional preponderance. Presence of spontaneous nystagmus and positional nystagmus has limited localising value. Butterfly chart is a good method of graphically presenting responses of caloric test and in depicting the status of labyrinth at a glance.
Authors and Affiliations
Kayedjohar K. Rathwala
Keywords
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- EP ID EP415109
- DOI 10.14260/jemds/2018/461
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