Balance issues affect more people than you might think. Research from Johns Hopkins shows that approximately one-third of adults over 40 experience some form of vestibular disorder, and that number jumps to half for those over 60. Here in South Park, we see Charlotte residents every week who struggle with dizziness, vertigo, or unsteadiness—conditions that significantly impact quality of life and increase fall risk.

At Hearing & Balance Solutions on Colony Road, we use Videonystagmography (VNG) testing to get to the root of these balance problems. This diagnostic tool helps us understand exactly what's happening in your vestibular system and guides us toward effective solutions.

Understanding VNG Testing

VNG testing evaluates how well your inner ear and brain work together to maintain balance and spatial orientation. Your inner ear contains tiny structures called the vestibular organs, which detect head movements and send signals to your brain. When these organs or the nerves connecting them to your brain aren't functioning properly, you experience dizziness, vertigo, or balance problems.

During a VNG test, you wear specialized goggles equipped with infrared cameras that track your eye movements with precision. Why focus on your eyes? There's a direct neurological connection between your inner ear and your eye muscles. When your head moves, your inner ear sends signals that cause your eyes to move in specific, predictable ways. By observing these eye movements, we identify problems in your vestibular system.

The test involves several components. We observe your eye movements while you're sitting still, track them as we move your head into different positions, and monitor them during specific maneuvers designed to trigger symptoms. Some portions involve following a moving light with your eyes, while others require you to lie down in various positions.

What VNG Testing Can Reveal

VNG testing provides detailed information about your balance system that helps us pinpoint the source of your symptoms.

Inner Ear Dysfunction

One of the most common findings from VNG testing is asymmetry between your left and right inner ear function. Your two vestibular systems should work in harmony, sending balanced signals to your brain. When one side is weaker than the other, your brain receives conflicting information, causing dizziness and imbalance.

VNG testing detects conditions like vestibular neuritis, where inflammation damages the vestibular nerve, typically following a viral infection. Patients with this condition experience severe, sudden dizziness that lasts for days. The test reveals characteristic patterns of eye movement that confirm the diagnosis.

BPPV Detection

Benign Paroxysmal Positional Vertigo, or BPPV, is one of the most common causes of vertigo. It occurs when tiny calcium crystals in your inner ear move into the wrong position, causing brief but intense episodes of spinning whenever you move your head in certain ways.

VNG testing is effective at identifying BPPV. During the positional portion of the test, we move you into positions that may trigger your symptoms while carefully observing your eye movements through the goggles. BPPV causes a distinctive pattern of eye movement called nystagmus that tells us exactly which ear is affected and which canal contains the displaced crystals.

The benefit of identifying BPPV through VNG is that it can be treated immediately. We perform specific head positioning maneuvers right in our office that guide the crystals back to where they belong, frequently resolving symptoms in a single visit.

Central Nervous System Issues

Most balance problems originate in the inner ear, but some stem from issues in the brain or brainstem. VNG testing helps distinguish between peripheral (inner ear) and central (brain-related) causes of dizziness.

Certain patterns of eye movement indicate that the problem lies within the central nervous system rather than the inner ear. When we identify these patterns, we coordinate with neurologists or other specialists to provide comprehensive care. Early detection of central causes is important because they may require different treatment approaches or signal underlying conditions that need medical attention.

Medication Side Effects

Some medications affect balance by impacting either the inner ear or the brain's processing of vestibular information. VNG testing reveals whether your balance system is functioning abnormally in ways consistent with medication effects.

Common culprits include certain antibiotics, blood pressure medications, and some antidepressants. When we identify medication-related balance issues, we work with your prescribing physician to explore alternative options that won't compromise your stability.

Age-Related Changes

As we age, our vestibular system naturally undergoes changes. The number of functioning hair cells in the inner ear decreases, and the signals sent to the brain may become less precise. VNG testing quantifies these age-related changes and helps us determine whether your symptoms are due to normal aging or if there's a treatable condition contributing to your balance problems.

Understanding the extent of age-related changes helps us develop targeted treatment plans. We can't reverse natural aging, but we implement strategies to help your brain compensate more effectively for the changes that have occurred.

The VNG Testing Experience at Our South Park Office

Preparing for your VNG test is straightforward. We recommend avoiding caffeine for 24 hours before your appointment, as it affects your eye movements and test results. If you're having VNG testing, skip eye makeup on the day of your test—it interferes with the cameras in the goggles. Wear comfortable clothing and flat shoes, and bring a list of your current medications.

The test itself takes 60 to 90 minutes. We start with a conversation about your symptoms: when they started, what triggers them, how they affect your daily activities, and any patterns you've noticed. This information helps us interpret your test results in the context of your specific situation.

Next comes the testing. You'll wear the specialized goggles throughout. Some portions of the test are performed while you're seated, others while you're lying down on an examination table. We guide you through each step, explaining what we're doing and what you might experience.

Feeling dizzy during certain parts of the test is normal—that's helpful information for us. If you do feel dizzy, it's temporary and part of the diagnostic process. We monitor you carefully throughout and take breaks as needed. Most patients handle the testing well, though some feel mildly dizzy or slightly nauseated during or immediately after. These sensations typically resolve quickly.

We recommend arranging a ride home after your test, just in case you feel temporarily unsteady.

From Diagnosis to Treatment

Once your VNG testing is complete, we analyze the detailed data to create a clear picture of your vestibular function. We look at the strength and symmetry of your vestibular responses, the patterns of eye movement in different positions, and how your balance system responds to various stimuli.

Many patients find relief from understanding what's causing their symptoms. Balance problems are frightening and frustrating, particularly when you don't know what's wrong. A clear diagnosis provides both explanation and direction for treatment.

Treatment depends on what the VNG reveals. For BPPV, we perform repositioning maneuvers during your visit. For vestibular weakness or asymmetry, we may recommend specific exercises designed to help your brain compensate for the imbalance. Some conditions require medication or coordination with other medical specialists.

At Hearing & Balance Solutions, we focus on identifying the root cause of your dizziness and imbalance, then guiding you toward the right solutions to help reduce fall risk and regain the confidence to maintain your independence. We provide comprehensive diagnostic services and, when appropriate, perform treatments like BPPV repositioning maneuvers. For patients who need ongoing vestibular rehabilitation, we maintain strong relationships with physical therapists who specialize in vestibular disorders.

Schedule Your VNG Testing in South Park

Dr. Gosu and our team at Hearing & Balance Solutions are ready to help you understand what's causing your balance problems and find effective solutions. We take the time to listen to your concerns, perform thorough testing, and explain your results in clear, understandable terms.

Don't let balance problems limit your activities or put you at risk for falls. Call us today at (704) 912-4422 to schedule your comprehensive balance evaluation at our South Park location. We're here to help you regain your stability, confidence, and independence.