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ENG/VNG Balance Testing

What are electronystagmography (ENG) and videonystagmography (VNG)?

ENG and VNG are common balance tests. They record eye movements to help your provider understand why you feel dizzy, off-balance, or like the room is spinning.

These tests can help show if your symptoms may be related to the inner ear, which helps control balance, or to how the brain uses balance signals.

ENG uses small sticky sensors placed near your eyes. VNG uses special video goggles placed over your eyes. Both tests look for eye movements called nystagmus.

During the test, your provider may ask you to watch moving lights, move your head or body, or lie in certain positions. You may also have a caloric test. During this part, warm or cool air or water is placed gently into one ear at a time. This helps your provider compare how the right and left inner ears respond.

An example of VNG testing 

Why Am I Having an ENG or VNG?

You may have this test to:

  • Help find the cause of dizziness, vertigo, or imbalance
  • Check how well each inner ear is sending balance signals
  • See how your eyes respond when your balance system is tested
  • Help tell if symptoms may be coming from the inner ear or the brain’s balance pathways
  • Help your provider plan treatment, therapy, or more testing

Is an ENG or VNG Safe?

ENG and VNG are usually safe tests. They do not involve needles or surgery.

Some parts of the test may briefly make you feel dizzy, nauseated, or off-balance. The caloric test may feel strange and may cause a spinning feeling for a short time. These symptoms usually fade soon after that part of the test ends. You can always tell your provider how you feel during testing.

You can ask to:

  • Take a break
  • Stop the test if needed

Ask your clinician if there are any other instructions or risks that apply to you.

Before Your Appointment

Your clinic may give you instructions to follow before your ENG or VNG test. These instructions help make sure your test results are as accurate as possible.

Your provider may ask you to:

  • Avoid alcohol for 24–48 hours before the test
  • Avoid caffeine on the day of the test
  • Eat a light meal before the test
  • Follow any instructions about when to stop eating or drinking

Some medicines can affect the test results. These may include medicines for dizziness, nausea, sleep, anxiety, or allergies.

Ask your provider which medicines you should take or avoid before the test. Do not stop taking any medicine unless your provider tells you to.

What to Wear

Wear:

  • Comfortable clothes
  • Flat shoes

Avoid:

  • Eye makeup
  • Oily lotions or heavy face products around the eyes, if your clinic recommends this

These products can interfere with the sensors or goggles.

What to Bring

  • Photo ID
  • Insurance card
  • A list of your medicines, or the medicine bottles
  • Glasses, hearing aids, or contact lens supplies, if you use them
  • Water and a small snack for after the test
  • Someone to drive you home, if needed

Should I Bring a Ride?

You may need a ride home.

Some tests can:

  • Make you feel dizzy for a short time
  • Cause nausea for a short time
  • Make it feel unsafe to drive right after

Ask your provider ahead of time if you should plan for a ride.

Questions To Ask Before the Test

To best prepare you for the testing and future results, you may want to ask:

  • Which parts of ENG or VNG will I have?
  • Which medicines should I stop, and when should I stop them?
  • Can I eat before the test?
  • How long should I plan to be there?
  • Can I drive after the test, or should I arrange a ride?
  • When and how will I get my results?
  • What happens if my results are normal?
  • What happens if my results are abnormal?
  • What symptoms after the test should make me call you?

During the ENG or VNG Test

What Will Happen?

During ENG or VNG, your provider records your eye movements while you do several short tasks. These tasks check how your eyes and balance system work together.

You may:

  • Have small sticky sensors placed near your eyes for ENG

  • Wear video goggles over your eyes for VNG

  • Sit in a dark or dim room for parts of the test

  • Follow moving dots, lights, or lines with your eyes

  • Keep your head still while your eyes track targets

  • Move your head or body into certain positions

  • Lie back or turn your head

  • Have warm or cool air or water placed gently into each ear, if caloric testing is included

  • Answer simple questions to help you stay alert

Not every person needs every part of the test.

The full test often takes about 60–90 minutes.

What to Expect During a VNG

How Might I Feel?

During the testing, you may feel:

  • Dizzy or like the room is spinning for a short time
  • Nauseated or sick to your stomach
  • A strange feeling in the ear during the caloric test
  • Tired by the end of testing
  • Mild headache or eye strain

These feelings are expected and usually do not last long. Mild symptoms during the test can help your provider better understand what is happening.

After the Test

How Will I Feel?

Most people feel okay within minutes to a few hours.

You may:

  • Feel mildly dizzy or unsteady for a short time
  • Feel tired
  • Feel nauseated for a while
  • Need to rest for the rest of the day
  • Feel better after eating, drinking water, and taking it easy

What Should I Do?

Plan for a calm day after testing, if you can.

  • Sit up slowly
  • Drink water
  • Eat a light snack if your stomach feels okay
  • Avoid driving until you feel steady and clear-headed
  • Ask when to restart any medicines you were told to stop
  • Rest in a safe place if you feel very dizzy
  • Ask for help walking if you feel unsteady

When Will I Get Results?

Some clinics can share basic findings the same day. Full results may take longer because they often need careful review and a written report.

Your provider may review the results with you at a follow-up visit, especially if the results affect your care plan.

When Should I Call My Provider?

Call your provider if you have:

  • Severe dizziness that does not improve
  • Dizziness that makes it hard to walk safely
  • Vomiting that will not stop
  • A new or worsening severe headache
  • Severe ear pain
  • Bleeding or drainage from the ear after testing

Call 911 or seek emergency care right away if you have:

  • New weakness or numbness
  • Trouble speaking
  • Trouble seeing
  • Fainting
  • Chest pain
  • Trouble breathing

Key Points to Remember

  • ENG and VNG record eye movements to help find the cause of dizziness, vertigo, or imbalance.
  • ENG uses sticky sensors near the eyes. VNG uses video goggles.
  • ENG and VNG are usually safe tests. They do not involve needles or surgery.
  • Some parts of the test may briefly cause dizziness or nausea.
  • Follow your clinic’s instructions about medicines, caffeine, alcohol, and eating before the test.
  • The test may include watching moving targets, changing positions, and warm or cool air or water in the ears.
  • Many people feel tired or dizzy after the test, so plan to take it easy.
  • Ask your clinician if there are any instructions not listed here that apply to you.

Additional Resources

  • Vestibular Disorders Association (VeDA) – ENG/VNG
  • MedlinePlus (NIH) – VNG
  • MedlinePlus (NIH):  ENG
  • MedlinePlus (NIH): Balance Tests
  • Vestibular Disorders Association (VeDA) – Sample ENG