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Quick Guide to VNG Interpretation

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1.  The purpose of VNG testing is To identify possible sites of lesion for balance disorders To use eye movements for assessing visual and vestibular responses to different stimuli To be utilized as part of a comprehensive balance assessment All of the above

2.  What is the role of the brain in the balance system? As one of the three major body senses that keep us balanced As integrator and coordinator As an observer of balance activity None of the above

3.  Which of the saccade abnormalities is sometimes recorded from normal individuals? Slow Saccades Delayed Saccades Undershoot Square Wave Jerks

4.  What is the difference between spontaneous nystagmus and positional nystagmus? Spontaneous nystagmus beats in the same direction at the same amplitude in each position; positional nystagmus changes in direction and/or amplitude in different positions Spontaneous nystagmus increases in intensity when vision is denied; positional nystagmus decreases in intensity when vision is denied Spontaneous nystagmus is commonly seen in patients with central lesions; positional nystamus is commonly seen in patients with peripheral lesions Spontaneous nystagmus is more fun to say than positional nystagmus

5.  If a patient has unilaterally defective tracking, what would you expect to find in the OPK responses? It depends on the health of the optokinetic visual system Unilaterally defective OPK results in the opposite direction Unilaterally defective OPK results in the same direction Bilaterally defective OPK results

6.  A unilateral weakness finding from the bithermal caloric testing indicates A central lesion A peripheral lesion A nonlocalizing lesion All of the above

7.  The best test in the VNG battery for assessing the proprioceptors is Bithermal caloric testing Dix Hallpike test Static position tests There are no tests for assessing proprioception in the VNG battery

8.  Abnormal results in the Dix Hallpike Should be documented and verified with a video recording of the eyes Can generally be determined from the tracing Are a non-localizing lesion All of the above

9.  Why has Gain Asymmetry taken the place of Directional Preponderance in many clinics? Gain Asymmetry is less specific Gain Asymmetry is less localizing Gain Asymmetry takes into account the position of the baseline Gain Asymmetry takes into account the temperature effect

10.  What should you do if you find a bilateral weakness in response to bithermal caloric stimulation? Ask the patient to come back in six months Rule out the possibility of technical errors Rule out the possibility of a tracking abnormality Do another four irrigations