Neurotological evaluation with NeuroEquilibrium™ equipment
Disequilibrium is caused by the disturbance in the harmonious functioning of the balance system of the human body, which is maintained by inputs from the eyes, inner ears (vestibular) and the proprioceptive system. It is a complex network with many components, including the
- Vestibulo-ocular reflex
- Vestibulospinal reflex
- Vestibulocollic reflex
- Otolith organs
- Vestibular nerve
- Central connections
These three systems send signals to the brain for proper coordination and maintenance of balance. A neurotological evaluation of vertigo and balance disorder patients covers an assessment of their functioning and coordination with our suite of breakthrough and patented diagnostic equipment.
Any disturbance in the harmonious functioning of these systems is diagnosed by our specialized neurotological team at the advanced vertigo and balance clinics, which evaluates each part of the vestibular system. Once its functional status has been assessed and affected areas identified, the management protocol is decided upon.
Video Nystagmography (VNG)
The Video Nystagmography (VNG) investigation evaluates the vestibulo-ocular reflex (VOR), which is an important part of the vestibular system to maintain balance. It also evaluates the oculomotor system, responsible for gaze stabilization and fixation.Using VNG, the doctor can evaluate and distinguish between peripheral and central vestibular disorders functions; decide the side affected and, in case of BPPV, determine the position of the otolith within the semicircular canals.
Subjective Visual Vertical (SVV)
Subjective Visual Vertical (SVV) is the test for the otolithsystem (the utricle and saccule) which is responsible for perception of verticality, and is especially useful for patients of chronic unsteadiness.
Craniocorpography (CCG) evaluates the vestibulospinal reflex, which is responsible for maintenance of balance during gait testing.
Dynamic Visual Acuity (DVA)
Dynamic Visual Acuity (DVA) is an investigation for detection of peripheral vestibulopathy and early detection of vestibulotoxicity. It assesses the ability of the subject to maintain the image on the fovea during head movement. This is an important function of VOR (vestibulocular reflex). In normal persons, the image of a moving target is maintained on the fovea by VOR. When the VOR system is impaired, visual acuity degrades substantially during head movement as the subject is not able to maintain the image on the retina, resulting in retinal slip and blurring of vision with a feeling of instability.
Electronystagmography (ENG) is also available at NeuroEquilibrium™ Diagnostic Systems though we recommend Video Nystagmography (VNG), which is a far more advanced test. As in VNG, this investigation evaluates the vestibulo ocular reflex (VOR), which helps in maintenance of balance. It also evaluates the oculomotor system, which is responsible for gaze stabilization and fixation. It helps to evaluate peripheral and central vestibular functions based on the following: