Patient Education | Vertigo (chakkar)

Published July 2026 | By Dr. Akansha Tewari, MS ENT, DNB

VNG Test: What It Is, How It Is Done and What the Results Mean

Videonystagmography (VNG) records eye movements to help assess the balance system. It can provide useful evidence in selected patients with Vertigo (chakkar), dizziness or imbalance, but it is one part of a complete clinical evaluation—not a diagnosis by itself.

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What it recordsInvoluntary and task-related eye movements.
What you wearLight-blocking goggles containing an infrared camera.
What you may doWatch targets and change head or body positions.
How it feelsPainless, although parts can briefly provoke dizziness or nausea.
The basic idea

What is a VNG test?

VNG stands for videonystagmography. It uses small infrared cameras inside special goggles to record your eye movements. The recording can show nystagmus—involuntary eye movement that may appear naturally or when the eyes, head or inner-ear balance organs are stimulated.

The eyes and inner ears work together through the vestibulo-ocular reflex. When the head moves, this reflex helps keep vision steady. Measuring eye movements therefore gives the clinician indirect information about how parts of the balance system are working.

VNG is different from an MRI or CT scan. It measures function; it does not create a picture of the brain or inner ear.
Vertigo assessment at HealthNest Clinic in Lucknow
Clinical purpose

Why might a doctor recommend VNG?

VNG may be useful when the history and examination leave questions about the vestibular system. It is not automatically required for every person who feels dizzy.

Symptoms that may lead to assessment

  • Repeated spinning or Vertigo (chakkar) episodes
  • Persistent imbalance or unsteadiness
  • Dizziness associated with head movement
  • Unexplained nausea or motion sensitivity
  • Symptoms accompanied by tinnitus, ear pressure or hearing change

Questions VNG may help address

  • Is there objective nystagmus?
  • Does changing position trigger a characteristic response?
  • Do the two inner-ear balance systems respond similarly?
  • Are eye-tracking findings outside the expected pattern?
  • Is more evaluation needed?
What the equipment does

How does VNG work?

The goggles record eye movements in light and darkness while a computer displays and measures them. Removing visual fixation can reveal nystagmus that may otherwise be suppressed when you focus on an object.

Oculomotor testing

You may follow moving dots or lights with your eyes. This looks at gaze, smooth pursuit and quick eye movements.

Positional testing

Your head and body are placed in selected positions to see whether a position produces Vertigo (chakkar) and a recognisable eye-movement pattern.

Caloric testing, when included

Warm and cool air or water may stimulate each ear separately. The resulting eye movements help compare vestibular responses between the ears.

Step by step

What happens during a VNG appointment?

History and ear examination

Your symptoms, triggers, medicines and previous reports are reviewed. The ears and relevant neurological or vestibular signs are examined.

Goggles are fitted

You sit in a chair or on an examination couch while the camera is aligned to record your eyes clearly.

Eye-movement tasks

You look at fixed or moving targets without moving your head unless instructed.

Head and body positions

You may sit, lie back, turn or hold different positions. Tell the examiner about neck or back limitations beforehand.

Ear stimulation if indicated

Selected protocols may use warm and cool air or water. This can cause brief Vertigo (chakkar), which usually settles.

Interpretation and plan

Recordings are considered together with your symptoms and examination. Further tests or treatment depend on the complete picture.

Before the appointment

How should I prepare for VNG?

Usually helpful

  • Bring previous hearing, VNG, scan and blood-test reports.
  • Bring a complete list of prescribed medicines, over-the-counter tablets and supplements.
  • Wear comfortable clothing that allows easy head and body movement.
  • Avoid eye makeup, mascara, eyeliner and heavy face lotion because they can interfere with camera tracking.
  • Follow the clinic’s instructions about meals; a light meal may be advised.

Important medication rule

Some medicines, alcohol and sedatives can alter eye movements or vestibular responses. However, do not stop any prescribed medicine on your own. Ask the clinic which medicines, if any, should be withheld and for how long. The decision depends on the medicine, your health and the purpose of testing.

If testing provokes dizziness, having someone accompany you or drive you home can be sensible.

Understanding the report

What can VNG results show?

Positional nystagmus

A particular pattern during positional testing may support BPPV and help identify the likely canal involved.

Asymmetry between ears

Caloric responses may suggest reduced vestibular responsiveness on one side, but the result must be interpreted clinically.

Eye-tracking findings

Unexpected oculomotor patterns may lead the doctor to review medicines, vision, attention or neurological causes and decide whether further assessment is needed.

A “normal” VNG does not mean the symptoms are imaginary. Some disorders, including vestibular migraine and PPPD, can have normal vestibular test results.
The limits matter

What can VNG not tell us?

  • VNG cannot diagnose every cause of dizziness by itself.
  • It does not replace a detailed history, bedside examination or hearing assessment.
  • It does not image the brain and does not replace MRI or other imaging when those are indicated.
  • A test abnormality does not always explain every symptom.
  • A normal result does not exclude all vestibular, neurological, cardiovascular or migraine-related causes.

The most useful report is one interpreted by a clinician who knows your symptom pattern and examination findings.

Safety and comfort

Does VNG hurt or have side effects?

VNG is non-invasive and should not be painful. Positional or caloric parts intentionally stimulate the balance system, so they may briefly cause dizziness, nausea or unsteadiness. Tell the examiner immediately if symptoms are severe. Most provoked symptoms settle after the stimulus stops.

Inform the clinic beforehand about significant neck or back disease, recent eye surgery, a perforated eardrum, ear surgery, severe vomiting tendency, pregnancy, mobility limitations or any condition that could affect positioning or testing.

Common questions

VNG test FAQs

Does everyone with Vertigo (chakkar) need VNG?
No. Many cases of typical BPPV can be diagnosed with bedside positional testing. VNG is selected when it is likely to add useful information or document vestibular function.
How long does a VNG test take?
The duration depends on the selected test battery and the patient’s symptoms. Ask the clinic for the expected appointment time when booking.
Can VNG diagnose BPPV?
VNG goggles can record the eye-movement pattern produced during positional testing and may help confirm and classify BPPV. The diagnosis still depends on the history and correctly performed manoeuvres.
Will the test make me dizzy?
Some parts may intentionally provoke short-lived dizziness so the response can be measured. Tell the examiner how you feel throughout the test.
Can I take my regular medicines before VNG?
Ask the clinic in advance. Some medicines influence test results, but stopping prescribed medicine without medical advice can be unsafe.
Can I drive after VNG?
Some people feel temporarily dizzy or unsteady afterward. Consider arranging transport, especially if your usual symptoms are severe or travel itself triggers dizziness.
What if my VNG result is normal?
A normal VNG does not rule out every cause of dizziness. Your doctor may consider vestibular migraine, PPPD, cardiovascular causes, medication effects or other investigations according to the clinical picture.
What should I bring?
Bring previous prescriptions, hearing tests, vestibular reports, scans and a current medication list. Wear no eye makeup unless the clinic tells you otherwise.
Are there contraindications to VNG?

There is no single contraindication that applies to every part of VNG, because the test is a battery of different procedures. The clinician may postpone, omit or modify specific components when needed.

  • Water caloric testing should not be used with a perforated eardrum, ventilation tube or certain postoperative ears. Ear examination is required; an alternative method may be considered.
  • Positional testing may need modification in people with significant neck or back disease, restricted neck movement, recent spinal surgery, suspected cervical instability or certain vascular conditions.
  • Testing may be postponed during an acute medical illness, uncontrolled vomiting or when the patient cannot safely sit, lie back or cooperate with instructions.
  • Recent eye surgery, significant visual difficulty, pregnancy, severe anxiety or mobility limitations should be disclosed so the protocol can be adapted appropriately.
  • Medicines can alter results, but prescribed medicines must never be stopped without individual medical advice.

Tell the clinic about ear surgery, eardrum perforation, neck or back problems, recent operations and all medicines before the appointment. These are often precautions requiring an adapted protocol rather than reasons to avoid the entire VNG.

Medical review

VNG is a tool, not a test package

At HealthNest Clinic, testing is considered after clinical assessment. The aim is to use VNG when it can answer a useful question, interpret it with your examination and turn the findings into a practical next step.

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Patient-information references

This page is for patient education and does not replace individual medical advice.