Abstract Background: Vertigo due to vestibular dysfunction is a common symptom in otorhinolaryngology clinics, and accurate diagnosis is very important to manage each case. Videonystagmography (VNG) is a useful diagnostic test used in evaluating vertigo of vestibular pathology. Aims: To describe the VNG patterns and its usefulness in various vestibular disorders. Materials and Methods: Prospective observational study over a period of 12 months with IEC approval. VNG was done for 80 patients diagnosed clinically as Vestibular dysfunction. Oculomotor, positional, caloric, and tests for gaze were done, and the parameters and abnormality were analyzed. Following Clinical and VNG-assisted diagnosis, patients were managed conservatively and followed up after 1 week. Statistical analysis of the Videonystagmograpy test parameters in various vestibular disorders was done. Statistical Analysis Used: Descriptive statistics, frequency, and percentages for categorical data, mean and standard deviation for continuous data using software SPSS version 26. Results: 85% were females and the mean age was 47 years. On the VNG, Saccades test was abnormal in 30%, smooth pursuit was abnormal in 50%, with the presence of saccadic intrusions. On Gaze test 27.5% had Grade 1, 17.5% had Grade 2, and 27.5% had Grade 3 nystagmus. In positional tests, Dix-Hallpike was positive in 82.5%, McClure Pagnini was positive in 30%. Modified Kobrak test showed hypofunctional labyrinth in 12.5%, comprising Meniers disease, vestibulopathy, and vestibular migraine. The presence of spontaneous nystagmus and hyperventilation-induced nystagmus was seen in patients diagnosed with vestibular migraine. As per VNG testing, 60% of patients were diagnosed as benign paroxysmal positional vertigo (BPPV), 10% as vestibular migraine, 5% as vestibular neuronitis, 2.5% as vestibulopathy, 12.5% as BPPV with vestibulopathy, 5% as Meniere’s disease, 2.5% as vestibular paroxysmia, and 2.5% as vertebrobasilar insufficiency. Following final diagnosis arrived based on both clinical examination and VNG testing, 58 (72.5%) had improvement in symptoms on follow-up at the end of 1 week. Conclusion: Our study corroborates the fact that VNG is a very useful tool in diagnosing and differentiating the various vestibular disorders.
Muddaiah et al. (Wed,) studied this question.