What can I expect of VNG Testing on Tuesday?

[ColaBurns]

Good evening everyone. I was diagnosed in June 2010 with a 4mm AN. My hearing seems to be ok...a little bit diminished on the right side where the tumor is but nothing to drastic. I'm also 28 so I understand that while I opted to watch and wait right now there is a very real chance of me having to have this thing treated in the near future. My biggest complaint is the dizzy spells / vertigo. Its gotten to the point where I have a hard time driving, focusing, dressing, etc. I have an appointment on Tuesday to have a balance test done (VNG) and I'm not quite sure what to expect although I was told no caffeine for 48 hours before hand. Has anybody had this done before? What exactly is it and what can I expect? The assumption right now is that the tumor is mostly compressing the balance nerve as there is no facial paralyis, very little tinitus and hearing is still good. I am not a fan of unneccessary surgery so I decided to watch and wait. If this VNG comes back showing I have balance issues what kind of response can I expect from my doc? I thought my balance/dizzyness was supposed to get better not worst. Anybody else deal with this? Thanks so much in advance for your response.

Cola

[TJ]

Cola

I have been in W&W for about 3 years although that might be changing soon.  I had the VNG test last year.  It helps the doctors to determine if the AN is causing the vertigo or is it being caused by something else.  They found out that mine was being caused by Meniere's Disease and not the AN.

The actual test takes a couple of hours and they recommend that someone else goes with you to drive you home.  It is not a difficult test as they put goggles on you and try to make you get dizzy or have vertigo.  They use special lights in the goggles and they also blow cold air and then warm air in each ear.  The whole time the technician is looking at your eyes to see what type of movement they have.

Piece of cake, hope all goes well for you

TJ

[FLsunshine]

I too have a 4mm AN and will be undergoing VNG testing as I've got balance issues.  I'm not scheduled until Nov 11th so can't give you any guidance on what to expect.  If your appt is earlier be sure to update this thread on how it went.

-- Suzanne

[tgillesp]

Cola,

I had VNG testing a few months ago.  I was also given a list of medications to stop taking at least 3 days before the test and told not to eat for 3 hours before the test.  You do get very dizzy and possibly nauseous.  You might want to ask about the medications if they did not tell you.  First I had to follow a beam of light back and forth and up and down with the goggles on.  Then, they blew warm air in the ears for while and then cold air for a while.  It was the hot and cold air that triggered my dizziness.  I was only dizzy on the left side, which meant something wasn't quite right on the right side.  Supposedly you are supposed to get dizzy.

[ColaBurns]

Thank you everyone. We have postponed the tests as I found out today I have some severe swelling and fluid buildup in that canal due to allergies. If the vertigo persists after the ear is taken care of then we will reschedule the VNG test. Thanks so much though for the heads up. I know now what to expect with this thing.

[FLsunshine]

Cola,

I had VNG testing a few months ago.  I was also given a list of medications to stop taking at least 3 days before the test and told not to eat for 3 hours before the test.  You do get very dizzy and possibly nauseous.  You might want to ask about the medications if they did not tell you.  First I had to follow a beam of light back and forth and up and down with the goggles on.  Then, they blew warm air in the ears for while and then cold air for a while.  It was the hot and cold air that triggered my dizziness.  I was only dizzy on the left side, which meant something wasn't quite right on the right side.  Supposedly you are supposed to get dizzy.

What treatment, if any, did you and your doc pursue after VNG test showed "something wasn't quite right on right side"? 

[jerseyboy]

Cola,
Both my AN size and symptoms are identical to yours, and I had VNG testing several months ago.  The results of the test showed that my brain is adjusting, now only accepting balance information from my AN side at a 50% rate, but 100% from the good side.  That was considered very positive, and is leading to a gradual reduction in the amount of dizziness and vertigo.  I understand vertigo happens when the brain gets conflicting balance information, and gets confused.  But if it adjusts to know good versus bad information, vertigo is reduced.  So, I think the VNG is really sort of like a stauts report.
Jeff

[patdel]

I just had that test today and it wasn't bad. You get dizzy for a few seconds when they shoot the air into the ear but it subsides fairly quickly. It's not a nice feeling but it sounds like you are familiar with the dizzy feeling already. I don't much off an issue with dizziness. Best of luck in your journey. Sounds like you have time to research since it's just 4mm at present.

Pat

[Tumbleweed]

The assumption right now is that the tumor is mostly compressing the balance nerve as there is no facial paralyis, very little tinitus and hearing is still good. ... I thought my balance/dizzyness was supposed to get better not worst.

Cola

Hi, Cola:

The facial nerve is far more resilient than either the balance or hearing nerve, so it would not likely present any symptoms until much farther along the progression of the tumor's growth. There are, of course, always exceptions. But the rule of thumb is that motor nerves (e.g., facial) don't get damaged as easily as sensory (hearing, balance) nerves.

Your vertigo and disequilibrium should abate over time, but it takes a long time for this to happen and your balance is, unfortunately, not likely to ever return completely to normal. However, it will probably eventually improve to the point where it is just a minor annoyance for you. The best thing you can do to speed up the recovery process is to walk, walk and then walk some more. The more often you walk, the faster your brain will adapt to (learn to ignore) aberrant balance signals it's receiving from your AN side, and your balance will improve that much faster.

Best wishes,
TW

[nftwoed]

Hi Cola;
   The ENG with calorics is a minor annoyance. If you don't experience the short periods of dizziness, that is canal paresis and a sign of the AN's impact upon the vestibular nerve.
   If you have good hearing and are that young ( 28 ), what do you feel is the logical outcome of the AN?
   'Watch and wait', is only good until the point the auditory nerve is affected. At your age it is likely to be involved in time. ( Just a couple/three short years. ) The better the hearing goinng into Tx, the better it is likely to be coming out of Tx. ( with the exception of larger CPA tumors )
   The auditory nerve is a sensory nerve, thus less resilient than the facial motor nerve. Sensory nerves cannot regenerate.
   Best wishes here! Not a good time to be lulled into complacency with another w & w MRI Dx!

[captoats]

Just had a VNG the other day at House.  Not a big deal at all.  They run cold and warm water in your ear while wearing total blackout goggles with IR cameras in them to watch your eye movements during the test.  You lay on a comfortable bench for about a half hour during the test.   I didn't get much of a dizzy sensation and the warm water in the ear actually felt pretty good!  I asked what the test shows and Dr. Brackmann said it indicates which balance nerve is involved.  You have a superior and inferior nerve on both sides.  Because my VNG test was normal, this indicates the tumor I have is most likely on the inferior nerve.  I guess if your test is abnormal, then the tumor is most likely on the superior nerve.

[Tumbleweed]

 I didn't get much of a dizzy sensation and the warm water in the ear actually felt pretty good!  I asked what the test shows and Dr. Brackmann said it indicates which balance nerve is involved.  You have a superior and inferior nerve on both sides.  Because my VNG test was normal, this indicates the tumor I have is most likely on the inferior nerve.  I guess if your test is abnormal, then the tumor is most likely on the superior nerve.

With all due respect, I believe you've misinterpreted what Dr. Brackmann told you. You cannot tell if the tumor is on the inferior or superior branch of the vestibular nerve based on how you react to water poured in the ear; you can only confirm which side of the head, left or right, has a damaged vestibular nerve. The AN side will produce less of a reaction because the nerve is weakened, and it doesn't matter whether the tumor is growing on the upper or lower branch as far as this response goes.

If I'm mistaken about this, somebody please correct me.

If the tumor is growing on the inferior vestibular nerve, however, and it is still small, the hearing nerve is less likely to be compromised.

Best wishes,
TW

[Cheryl R]

I may be wrong but I thought if the AN was on the superior nerve it was less likely to affect the acoustic nerve.       They are on the inferior nerve more often I am thinking but again could be wrong as I don't check into AN info as much as used to.   
  I do know my surgeon thought my last AN on the left was on the superior pre op from just the MRI.                Cheryl R

[Tumbleweed]

Cheryl, you are totally correct. I meant to write superior instead of inferior. That's what I get for posting so late when I'm dead tired. The inferior vestibular nerve is immediately above the hearing nerve, so a tumor on the inferior vestibular nerve is more likely to press on the hearing nerve and cause problems. The superior vestibular nerve is above the inferior vestibular branch and thus farther away from the hearing nerve.

Thanks for correcting me on this. I'd hate to have my wrong information linger uncorrected on this forum.

Best wishes,
TW

[sgerrard]

If we are correcting information, I believe that the VNG tests can discriminate between inferior and superior balance nerve issues.

As I understand it, the inferior balance nerve is not involved with the semi-circular canal or most of what we would call the usual balance issues. In my case, anyway, it was separately tested by looking at a reflex reaction in the neck muscles, and I believe it is involved in detecting rotation of the head, not up-down orientation. When the VNG test gives near normal superior nerve responses, the inferior nerve is indicated as the likely location of the AN. That is based on my reading of the vestibular lab reports on my case, which indicated the inferior branch as the most likely location.

Steve