Videonystagmography and Posturography

Videonystagmography (VNG) and posturography are two vestibular assessment techniques that are still in use today. VNG: VNG allows clinicians to observe and record eye movements in real-time. Compared with electronystagmography (ENG), VNG tracings are more detailed and can capture subtle clinical findings. The utility of the monothermal caloric screen has been proposed in various studies. When appropriate cut-offs are used, the monothermal screen can be completed with a low false-negative rate. Air is often used as a medium for caloric testing, though not without some controversy. When air and water are compared, the response magnitudes for air are consistently smaller than for water. However, the overall classification of the result appears to be generally the same regardless of the caloric medium used. Posturography: Concerns have been raised about the reliability and validity of posturographic measurements. Approaches and analysis techniques vary widely, and there is little consensus regarding the best approaches for assessment or interpretation. There is a need for standardized protocols. The portable and low-cost Nintendo Wii Balance Board (WBB) has inspired a surge in publications looking at the validity of the system for quantifying posturography and for balance training; preliminary findings are very promising.