３．　電気眼振図　（ＥＮＧ）　の検査法と診断的意義について

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  • Diagnostic significance and test methods of electronystagmography (ENG)

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Electronystagmography (ENG) is an equilibrium function test that records eye movements. Its objectives are to detect asymmetry in peripheral vestibular function and to detect central nervous system disorders. The merits of ENG are as follows: 1) various types of eye movements, including nystagmus, can be recorded; 2) nystagmus can be quantitatively analyzed; and 3) eye movement with the eyes closed and with the eyes open in darkness can be recorded. A weakness of ENG is that while it can record eye movement in the horizontal and vertical directions, it is not capable of recording rotatory eye movements. In clinical practice, ENG is used to detect the following: 1) spontaneous ocular motility in bright light and in the absence of fixation (with the eyes closed and with the eyes open in darkness); 2) gaze nystagmus; 3) positional nystagmus; 4) positioning nystagmus; 5) smooth pursuit; 6) optokinetic nystagmus; 7) saccade; 8) rotatory nystagmus; 9) caloric nystagmus; and 10) visual suppression. ENG can be performed with either binocular or monocular leads, and the latter is used particularly for recording of dysconjugate ocular motility, which occurs with supranuclear ocular motility disorders such as MLF syndrome. Although ENG is being used for diagnosis of dizziness and disequilibrium, we must not place too trust on the results of ENG tests. ENG is only a test of eye movement, and the causal relationship between ENG results and lesions must be determined by the users themselves. Recently, the use of videooculography (VOG) using an infrared CCD camera that also enables recording of rotatory eye movements has gradually spread, while the use of ENG is in decline.

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