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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/28 13:48:57」(JST)

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Electronystagmography (ENG) is a diagnostic test to record involuntary movements of the eye caused by a condition known as nystagmus. It can also be used to diagnose the cause of vertigo, dizziness or balance dysfunction by testing the vestibular system.

Technique and results

The test is performed by attaching electrodes around the nose and measuring the movements of the eye in relation to the ground electrode. The vestibular system monitors the position and movements of the head to stabilize retinal images. This information is integrated with the visual system and spinal afferents in the brain stem to produce the vestibulo-ocular reflex (VOR). ENG provides an objective assessment of the oculomotor and vestibular systems. A newer standard for the recording is the use of infrared video systems which allow for a more detailed observation and analysis of these eye movements, called video nystagmography (VNG). A similar test is performed for testing vertigo by using the caloric reflex test, which can be induced by air or water of specific temperatures, typically ± 7 degrees Celsius from body temperature.

The standard ENG test battery consists of three parts:

oculomotor evaluation
positioning and positional testing
caloric stimulation of the vestibular system

The comparison of results obtained from various subtests of ENG assists in determining whether a disorder is central or peripheral. In peripheral vestibular disorders, the side of lesion can be inferred from the results of caloric stimulation and, to some degree, from positional findings.

ENG or VNG can be used to record nystagmus during oculomotor tests such as saccades, pursuit and gaze testing, optokinetics and also calorics (dithermal or monothermal). Abnormal oculomotor test results may indicate either systemic or central pathology as opposed to peripheral (vestibular) pathology.

Optokinetics generally are used as a cross-check on abnormal responses to oculomotor tests. Both of these tests use a "light bar" involving a moving light (usually red) which the patient will track with the eyes.

The caloric irrigation is the only vestibular test which allows the clinician to test the vestibular organs individually; however, it only tests one of the three semicircular canals: the horizontal canal.

While ENG is the most widely used clinical laboratory test to assess vestibular function, normal ENG test results do not necessarily mean that a patient has typical vestibular function. ENG abnormalities can be useful in the diagnosis and localization of the site of lesion; however, many abnormalities are nonlocalizing; therefore, the clinical history and otologic examination of the patient are vital in formulating a diagnosis and treatment plan for a patient presenting with dizziness or vertigo.

References

External links

Vestibular Testing - Timothy C. Hain, MD
eMedicine - Electronystagmography

English Journal

[Physiological nature and diagnostic implications of rotational nystagmus].

Usachev VI, Dotsenko VI.AbstractThe authors provide a rationale for clinical studies of four types of rotational nystagmus, true vestibular, cervico-vestibular, opto-vestibular, and cervico-optovestibular. A physiological concept of nystagmus during active head rotation is formulated. Negative consequences of vestibular nystagmus as a pathophysiological reaction are discussed. The main criteria for nystagmometric differential diagnosis of peripheral vestibular and central disorders are proposed. Diagnostic potential of the new <<Neuro-KM - Electronystagmograph>> system is demonstrated.
Vestnik otorinolaringologii.Vestn Otorinolaringol.2010;(1):58-63.
The authors provide a rationale for clinical studies of four types of rotational nystagmus, true vestibular, cervico-vestibular, opto-vestibular, and cervico-optovestibular. A physiological concept of nystagmus during active head rotation is formulated. Negative consequences of vestibular nystagmus
PMID 20436427

[Otoneurological findings in a case of congenital central hypoventilation syndrome (Ondine's curse)].

Gallina S, Restivo S, Cupido G, Speciale R, Giammanco AM, Cimino G.SourceClinica Otorinolaringoiatrica Base, Policlinico Universitario di Palermo.
Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale.Acta Otorhinolaryngol Ital.2000 Apr;20(2):121-4.
The authors report a case of congenital central hypoventilation syndrome (CCHS) studied from the otoneurological point of view. Emphasis is placed on the numerous alterations in the electronystagmograph and auditory potentials. The results obtained confirm the hypothesis that such patients are subje
PMID 10992604

Japanese Journal

後頭蓋窩くも膜嚢胞によるめまいの1 例

日大医学雑誌 73(4), 186-190, 2014
NAID 130005070923

眼振の記録 ENGの原理と記録方法 (平衡機能検査) -- (平衡機能の検査)

臨床検査 52(12), 1445-1449, 2008-11
NAID 40016353617

めまいが初発症状であった巨大小脳動静脈奇形例

耳鼻咽喉科臨床 101(10), 759-764, 2008-10-01
NAID 10022621107

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