INSTRUCTIONS FOR VIDEONYSTAGMOGRAPHY (VNG) The VNG is a group of tests looking at the balance functions of the inner ear and brain which provides information about the source of your dizziness or unsteadiness. We schedule 2 hours for the test, however, it may take as little as 1 hour to complete. Many people experience some dizziness during the test however, it usually does not last long. It is therefore strongly recommended that a friend or relative drive you home following the test. To record any dizziness experienced throughout the test you will be looking through lightweight goggles equipped with miniature video cameras. Instructions for Testing
1. Avoid wearing make-up, especially eye make-up. 2. Wear comfortable clothing and flat shoes 3. Eat only a light meal not more than 2 hours before testing. 4. Please do not take any of the following medications/substances for 48 hours prior
to testing. These substances can influence the body’s response to this test and give false responses.
Alcohol Allergy Medicine Anti-histamines Anti-Nausea Medicine Anti-Vertigo Medicine (Meclizine/Antivert) Caffeine Cough Syrup Sedatives Tranquilizers
Please continue taking any medications for your heart, blood pressure, diabetes, seizures, etc. If you have any questions prior to testing, please contact Dr. Nancy Hart at 410-857-3800. DIZZINESS QUESTIONNAIRE
When you are “dizzy” do you experience any of the following sensations/symptoms? Check all that apply.
Spinning Lightheadedness Swimming sensation in the head Black out/Loss of consciousness Hearing Loss Headache Tinnitus (noises in the head/ears) Full feeling in the ear(s) Nausea/vomiting Pressure in head Sensitivity to light/noise Tendency to fall – right – left – forward – backward
Describe your “dizziness” attack/s
Is your dizziness constant or in attacks? _____________________________ When did first attack occur? ______________________________________ How long since last attack? _______________________________________ How often do the attacks occur? ___________________________________ How long do they last? __________________________________________ What, if any, warning signs do you have before an attack? _____________________________________________________________ Does dizziness occur in certain body/head positions? _____________________________________________________________ Are you completely free of dizziness between attacks? _________________ Do you know of any possible causes for your dizziness? _____________________________________________________________
Do you know of anything that will stop your dizziness or make it worse?________________________________________________________ Were you exposed to any irritating fumes, paints, etc at the onset of your dizziness? ____________________________________________________ Health questions - Check all that apply
Have you ever had ear surgery? Difficulty with hearing? Fluctuating hearing loss? Pain/Discharge in ears? Have you ever been exposed to or work in loud noise? Do you have any allergies? Do you use tobacco? Do you use alcohol? Do you or have you ever had cold sores/shingles/Herpes Simplex virus? Do you have autoimmune issues such as Rheumatoid Arthritis? Do you have acute ear/sinus infections? Do you have Diabetes? Do you have high or low blood pressure?
Please list any medications/supplements you take regularly _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ What brings on your dizziness? Check all that apply.
Do you get dizzy after exertion or overwork? Does heavy lifting or straining bring on dizziness? Did you recently get new glasses/contacts? Do you get dizzy if you miss a meal? Do you get dizzy when standing up? Do you get dizzy when looking up? Do you get dizzy when bending over? Do you get dizzy with quick head movements? Do you get dizzy turning over in bed? Right? Left? Do you tend to get stressed easily?
Have you ever had a neck or back injury? Do you get dizzy walking down the aisle in the grocery store? Do loud sounds make you dizzy? Does pressure in your ear make you dizzy? Does dizziness occur just prior to your menses cycle?
Have you ever experienced any of the following symptoms? Check all that apply.
Double vision Numbness of face or arms/legs Blurred vision or blindness Weakness in arms/legs Confusion or loss of consciousness Difficulty with speech Difficulty with swallowing Tingling around the mouth
Please describe your dizziness in your own words and note any additional information that may be helpful in treating your dizziness.
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DIZZINESS QUESTIONNAIRE