About The Book
Electronystagmography and Videonystagmography (ENG/VNG), Second Edition remains a practical and portable resource for conducting and interpreting the electronystamography/videonystagmography examination.
In order to provide a foundation for understanding ENG/VNG test results, the early sections of the text are dedicated to a description of normal and impaired peripheral and central vestibular system function. Also addressed is the process of central nervous system compensation. These sections are followed by a description and interpretation of the ENG/VNG subtests including: an expanded ocular motor testing section, positional/ing testing, and caloric testing. The text now also includes a chapter describing the most common disorders causing dizziness and provides the diagnostic criterion for each. Finally, examples of counseling materials and illustrative case studies that serve to highlight the principles and techniques covered in the manual are provided.
Graduate students and practicing clinicians will benefit from this unitary source for protocols and procedures required for completing an ENG/VNG examination.
New to the Second Edition
- New illustrations demonstrating key concepts within the text
- New and updated references throughout
- New chapters describing common disorders
- Updated and expanded chapter on ocular motor function
- 10 cases with 17 videos accessible on a PluralPlus companion website
From the Foreword
“Now we have before us the second edition of Dr. McCaslin’s book, and it’s even better than the first. Same firsthand clinical experience, same serious scholarship, same lucid writing, but now there’s updated and expanded information on eye movement neurophysiology and a new set of illustrations. Also new is a whole chapter listing common (and some not so common) dizziness-causing disorders. Dr. McCaslin has outdone himself here. For each disorder, he provides historical background, pathophysiology, clinical presentation, laboratory findings, and treatment. He also provides several useful appendices—a dizziness questionnaire, suggested alerting tasks to be used during caloric testing, and a table listing reliability and localizing value of various ENG/VNG findings.
Who is this book for? It should be required reading for all clinicians who perform ENG/VNG and for all students who aspire to do so. It should also be read by referring physicians. ENG/VNG test results alone rarely yield a diagnosis, but they often provide useful information to physicians who understand their implications and relate them to other medical data available for diagnosis. One need not look elsewhere to find cogent descriptions of ENG/VNG results and their implications. They’re in this book. I learned a lot. You will, too.”
—Charles W. Stockwell, PhD
About The Author
Devin L. McCaslin, PhD received a Master’s degree in Audiology from Wayne State University and a PhD in Hearing Science from The Ohio State University. He currently serves as the Director of the Vestibular and Balance Laboratory at Mayo Clinic in Rochester and is an Associate Professor in the Mayo Clinic College of Medicine. He has authored and coauthored publications that cover the areas of tinnitus, dizziness, auditory function, and outcome measures development. Dr. McCaslin’s major academic, clinical and research interests relate to clinical electrophysiology, vestibular assessment, and the application of artificial intelligence to manage and treat dizzy patients. He also serves as the Deputy Editor-in-Chief of the Journal of the American Academy of Audiology and is the Past President of the American Balance Society.
Table Of Contents
Chapter 1. Neural Control of Eye Movements
Introduction
Hierarchy of Oculomtor System
The Final Common Pathway of the Oculomotor System
The Functional Classes of Eye Movements
Eye Movements that Keep the Fovea Fixed on a Target
Optokinetic System
Chapter 2. Anatomy and Physiology of the Vestibular System
Introduction
The Sensory Transduction of the Peripheral System
Vestibular Hair Cells
Semicircular Canal Anatomy and Physiology
Otolith Organ Anatomy and Physiology
Primary Vestibular Afferent Projections
Anatomy of the Central Vestibular System
Vestibular Nystagmus Generated by Head Movement
The VOR during Sustained Movement
Peripheral Vestibular Impairment and Central Nervous System Compensation
Impaired Central Nervous System Compensation
Laws of Compensation
Chapter 3. Pretest Procedures for VNG
Introduction
Case History
The Dizziness Symptom Profile (DSP)
Assessment of Dizziness Handicap
Bedside Evaluation of the Ocular Motor System
Otoscopic Examination
The VNG Environment
Chapter 4. Eye Movement Examination
Introduction
Instrumentation
EOG/ENG: Corneoretinal Potential
Using the CRP to Record Eye Movements
Voluntary Saccade Test
Gaze Test
Smooth Pursuit Tracking Test
Optokinetic Test
Chapter 5. Positional Testing
Static Positional Testing
Positioning Testing
Treatment of Benign Paroxysmal Positioning Vertigo
Chapter 6. The Caloric Test
Introduction
Caloric Stimulation of the Vestibular System
Components of the Caloric Test
Instrumentation
Preparation for the Caloric Test
Procedure for Conducting the Alternating Binaural Bithermal Caloric Test (Water and Air)
Caloric Test Technique
Analysis of Caloric Responses
Interpretation of Caloric Responses
Summary: Significance of a Directional Preponderance
Technical Tips for Caloric Testing
Chapter 7. Common Vestibular Disorders: Clinical Presentation
Introduction
Common Disorders Causing Dizziness
Appendix A. Dizziness Questionnaire
Appendix B. Understanding Dizziness
Appendix C. Pediatric Literature for Understanding Dizziness
Appendix D. Example Alerting Tasks for Vestibular Testing
Appendix E. Reliability and Localizing Value of VNG Findings
References
Index
Videos
This book comes with supplementary case videos on a PluralPlus companion website.
Case 1: Downbeat Gaze Nystagmus (1 video)
Case 2: Bidirectional Gaze-Evoked Nystagmus (2 videos)
Case 3: Hypermetric Saccades (1 video)
Case 4: Infantile Nystagmus (2 videos)
Case 5: Ocular Flutter (1 video)
Case 6: Slow Saccades (2 videos)
Case 7: Spontaneous Vestibular Nystagmus (4 videos)
Case 8: Posterior Canal Benign Paroxysmal Positional Vertigo (1 video)
Case 9: Square Wave Jerks (1 video)
Case 10: Geotropic Horizontal Canal Benign Paroxysmal Positional Vertigo (2 videos)
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