Laboratory Test Methods and Principles in Vestibular Evaluation

Vestibular diseases can be peripheral, central, or mixed. Vestibular-origin complaints affect approximately 8% of the population. The prevalence of vestibular pathology and the risk of falls increase with aging. An audiovestibular evaluation protocol includes hearing tests, clinical/bedside vestibular tests, and laboratory vestibular tests. Assessment of the vestibular functions requires a battery of tests and an algorithm. Since vertigo and imbalance are subjective complaints, both clinical and laboratory vestibular tests should be performed. Laboratory vestibular tests primarily include videonystagmography (VNG) (including the positional and caloric tests), the video head impulse test (vHIT), and the vestibular-evoked myogenic potential (VEMP; both cervical and ocular) test. This chapter contains up-to-date information on the application and interpretation of laboratory vestibular tests.