ENG in the emergency room: subtest results in acutely dizzy patients

A retrospective analysis of electronystagmography (ENG) subtests performed on 93 acutely dizzy patients in the emergency room (ER) shows that "pendular tracking" has high sensitivity and specificity for determining central pathology. Small combinations of subtests altered sensitivity or specificity only slightly over pendular alone. Detection of spontaneous nystagmus was also helpful in ruling out "other" diagnoses such as hyperventilation syndrome, psychogenesis, or malingering. Popularity of the shortened ENG in the ER was evidenced by the high rate of charting of results and the frequency with which the test was requested after the study terminated. ENG also identified four cases of previously unsuspected central nervous system (CNS) lesion.