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Positional testing provides information regarding development of nystamus when your head is placed in certain positions.  A minimum of five (5) and often seven (7) positions are used in a standard VNG (videonystagmogram) protocol.  These positions include:

  • Hallpike position right
  • Hallpike position left
  • Supine (on your back) with head elevated 30 degrees
  • Supine head right
  • Supine head left
  • Body right
  • Body left

The protocol for positional testing involves wearing the infrared video goggles and eye movements are monitored for 30-60 seconds when placed in each position.  Testing in this manner gives us information about positional or positioning nystagmus.  This is the portion of the evaluation which determines the presence of BPPV.  However, there are many disease states other than BPPV that cause vertigo and/or nystagmus that is positional.  Thus the importance of visualizing the type and characteristics of any nystagmus that develops in each head position.

To learn more about the different parts of the VNG, follow the links below:

Central (brain) tests
Positional testing
Caloric testing
Rotary chair
VEMP (vestibular evoked myogenic potential)

Positional Testing