Videonystagmography (VNG) Testing in Houston

If you’re experiencing dizziness, vertigo, imbalance, or unexplained falls, the problem isn’t always in your ears—it’s often in how your brain processes balance signals.

At St. Michael Clinics, Videonystagmography (VNG) is used as a precise neurological diagnostic tool to identify abnormalities in the vestibular system and central nervous system, especially in patients with concussion, traumatic brain injury, or persistent balance disorders.

We provide VNG testing for patients throughout Houston, Sugar Land, Clear Lake, and the Texas Medical Center.

What Is Videonystagmography?

Videonystagmography (VNG) is a computerized diagnostic test that evaluates the balance system by measuring involuntary eye movements, known as nystagmus.

Because eye movements are directly controlled by the brain and vestibular pathways, even subtle abnormalities can reveal:

Inner ear dysfunction

Central nervous system involvement

Post-concussion or post-traumatic balance impairment

The test uses infrared video goggles with high-resolution cameras to objectively record eye movements during specific visual and positional tasks.

Why Eye Movements Matter in Balance Disorders

Balance depends on precise communication between:

The inner ear (vestibular system)

The eyes

The brain

When this system is disrupted—by concussion, TBI, stroke, or vestibular disease—the eyes often move abnormally, even when symptoms are difficult to describe.

VNG allows us to detect these abnormalities without relying on subjective reporting, making it especially valuable in complex neurological cases.

When Is Videonystagmography Recommended?

Your physician may recommend VNG testing if you experience:

Vertigo or spinning sensations

Persistent dizziness or lightheadedness

Unexplained falls or balance problems

Difficulty with coordination or walking

Tinnitus or ringing in the ears

A feeling of pressure or fullness in the ears

Symptoms that worsen with head movement

Ongoing balance issues after concussion or brain injury

VNG is frequently used when symptoms persist despite normal MRI or CT imaging.

How to Prepare for a Videonystagmography Test

VNG requires minimal preparation, but following instructions closely ensures accurate results.

You may be advised to:

Avoid medications that affect balance (your provider will guide you)

Avoid alcohol and caffeine before the test

Refrain from eating solid foods for at least two hours prior

Avoid eye makeup, especially mascara

Remove contact lenses (glasses are allowed)

Clean your ears thoroughly before testing

Always provide a complete medical and medication history before the test.

What Happens During Videonystagmography?

The test typically lasts about one hour and includes several components designed to assess different aspects of vestibular and neurological function.

Infrared Goggle Setup

You’ll wear lightweight goggles equipped with infrared cameras that precisely track eye movements and send data to a computer system for analysis.

Spontaneous Nystagmus Testing

Eye movements are recorded while you sit still and focus on a stationary target to identify abnormalities without stimulation.

Gaze Testing

You’ll follow moving visual targets to assess how the vestibular system responds to changes in eye position.

Positional Testing

Your head and body are moved into specific positions to provoke eye movements associated with balance disorders, including positional vertigo.

Caloric Testing

Warm and cool air or water gently stimulates each inner ear independently to evaluate vestibular responsiveness and symmetry.

Optokinetic Testing

Moving visual patterns assess how your eyes and brain respond to visual motion.

Throughout the test, eye movements are recorded objectively and cannot be influenced by patient effort or examiner interpretation.

What Happens After VNG Testing?

It’s common to feel temporarily dizzy during or shortly after the test. This typically resolves quickly.

If dizziness persists, you may need someone to drive you home. Your provider will review the results and discuss next steps.

How VNG Results Are Interpreted

Abnormal VNG findings can indicate dysfunction in the vestibular system or central nervous system.

VNG helps diagnose conditions such as:

Benign paroxysmal positional vertigo (BPPV)

Vestibular neuritis

Labyrinthitis

Ménière’s disease

Acoustic neuroma

Central vestibular disorders

Post-concussion and post-traumatic balance dysfunction

At St. Michael Clinics, results are interpreted in the context of:

Neurological examination

Cognitive and balance testing

Brain injury history

Other advanced diagnostics when needed

This integrated approach ensures findings are clinically meaningful—not just technical data.

Common Questions About Videonystagmography

Is videonystagmography painful?

No. VNG is non-invasive, though some parts of the test may briefly provoke dizziness.

How long does a VNG test take?

Most tests take about one hour from start to finish.

Can VNG detect post-concussion balance problems?

Yes. VNG is particularly effective at identifying vestibular dysfunction associated with concussion and traumatic brain injury.

Do I need imaging before VNG?

Not necessarily. VNG often reveals functional abnormalities even when MRI or CT scans appear normal.

Do you offer VNG testing in Houston?

Yes. St. Michael Clinics provides videonystagmography testing for patients throughout the Houston area.