ELECTRONYSTAGMOGRAP

HY
Hanna Rafia Naing
Arthur Clyd Jerome Nogas
Abdelmar Susulan
Patricia Mae Tusin
What is ELECTRONYSTAGMOGRAPHY?
• Electronystagmography (ENG or electrooculography) is used to evaluate people
with vertigo (a false sense of spinning or motion that can cause dizziness) and
certain other disorders that affect hearing and vision.

• Electrodes are placed at locations above and below the eye to record electrical
activity.

• By measuring the changes in the electrical field within the eye, ENG can detect
nystagmus (involuntary rapid eye movement) in response to various stimuli. If
nystagmus does not occur on stimulation, a problem may exist within the ear,
nerves that supply the ear, or certain parts of the brain. This test may also be used
to distinguish between lesions in various parts of the brain and nervous system.
ANATOMY OF THE EAR
• External or outer ear - This consists of the pinna or auricle (the outside part of the ear) and
the external auditory canal or tube (the tube that connects the outer ear to the inside or
middle ear)

• Tympanic membrane(also called the eardrum) - The tympanic membrane divides the
external ear from the middle ear.

• Middle ear (tympanic cavity) - This consists of ossicles (three small connected bones) that
transmit sound waves to the inner ear, and the eustachian tube (a canal that links the middle
ear with the throat area).

• Inner ear - This consists of the cochlea (contains the nerves for hearing), the vestibule
(contains receptors for balance), and the semicircular canals (contain receptors for balance).
 DIFFERENT TYPES OF ENG
TESTS
• Calibration test - This involves following a light about 6 to 10 feet
away with your eyes. This test measures ocular dysmetria (a
condition in which movements of the pupil of the eye overshoot
their target).

• Gaze nystagmus test - This involves staring at a fixed light placed

either to the center or side as you are seated or lying down. This
test measures how well you can fix your gaze at an object without
your eyes moving involuntarily.

• Pendulum-tracking test - As its name suggests, this test measures

how well you can follow a light with your eyes as it moves like the
pendulum of clock.
 DIFFERENT TYPES OF ENG
TESTS
• Optokinetics test- This measures your ability to follow a light as it
moves quickly across and out of your field of vision and back
again while you keep your head still.

• Positional test - This involves moving your head and perhaps your
whole body as opposed to just your eyes. For example, you may be
instructed to turn your head quickly to one side, or you may be
asked to sit up quickly after you have been lying down. The
amount of eye motion that results from this activity is recorded.
 DIFFERENT TYPES OF ENG
TESTS
• Water caloric test. - This involves introducing warm or cool water
into the ear canal with a syringe so that it touches the tympanic
membrane. If no problem exists, your eyes will move involuntarily
to this stimulus. Air instead of water may be used as the stimulus
for this test, especially in those who have a damaged tympanic
membrane.
RISKS OF THE
PROCEDURE
● ENG is associated with minimal risks. Some
people may experience dizziness or nausea
during the test.

● Back or neck problems may be aggravated by

rapid changes in position required for the test.

● The water caloric test may produce mild

discomfort. Patients who have previously been
diagnosed with a perforated tympanic
membrane should not undergo the water caloric
portion of the ENG test.
RISKS OF THE
PROCEDURE
Certain factors or conditions may interfere with
ENG. These include, but are not limited to, the
following:

• Earwax
• Impaired vision
• Frequent blinking
• Certain medications, such as sedatives,
tranquilizers, and antivertigo medications

There may be other risks depending on your specific

medical condition. Be sure to discuss any concerns
with your doctor prior to the procedure.
BEFORE THE
PROCEDURE…
• Your doctor will explain the procedure to you and offer you the opportunity to
ask any questions that you might have about the procedure.

• You may be asked to sign a consent form that gives your permission to do the
procedure. Read the form carefully and ask questions if something is not clear.

• You may be asked to avoid eating for at least four hours before the test.

• Avoid consuming caffeine and alcohol for 24 to 48 hours before the test.

• Notify your doctor of all medications (prescribed and over-the-counter) and

herbal supplements that you are taking.
• Discontinue taking sedatives, tranquilizers, and any other medications as
instructed by your doctor before the test.

• Clean your ears of excessive earwax. Before the ENG, your ears will be
examined for the presence of wax, inflammation, or other problems that may
interfere with the test.

• If you wear eyeglasses and/or a hearing aid, bring them with you to the test.

• Based on your medical condition, your doctor may request other specific
preparation.
DURING THE PROCEDURE
Generally, the ENG follows this process:

1. If there is wax in the ear, it will be removed.

2. Before positioning the electrodes, areas of the skin on your face will be
cleaned with an alcohol-saturated cotton pad and allowed to air-dry.

3. A paste will be used to attach the electrodes. One electrode will be

positioned in the center of your forehead, and the other electrodes will be
positioned above the eyebrow and below the eye in a way that allows you to
close your eyes. Electrodes may also be placed to the side of each eye.
DURING THE PROCEDURE
4. Depending on the type of test being performed, you may be asked to look
up, down, or to the side or move your head and/or entire body. You may
also be asked to close your eyes, which does not hinder the recording of
eye movement.

5. For caloric testing, either air or water will be introduced to

the ear while eye movements are recorded.

6. The electrical activity detected by the electrodes will be

fed into a recorder, which amplifies the signal and charts it
so that your doctor can interpret the results.
AFTER THE PROCEDURE

● Once the test is complete, the electrodes will be removed, and the electrode paste
washed off. You may be instructed to avoid rubbing your eyes to avoid spreading
the electrode paste.

● You will be observed for any signs of weakness, dizziness, and nausea, and may
need to lie down or sit for a few minutes to recover.

● Your doctor will inform you as to when to resume any medications you stopped
taking before the test.

● Your doctor may give you additional or alternate instructions after the procedure,
depending on your situation.
THANK YOU !
Resources
● https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/electronystagmography-
eng#:~:text=Electronystagmography%20(ENG%20or%20electrooculography)%20is,eye%20to%20record%20electrical
%20activity.
Grade:

Leader:
Arthur Clyd Jerome Nogas = 100%

Members:
Abdelmar Susulan = 100%
Patricia Mae Tusin = 100%
Hanna Rafia Naing = 100%