Concussions, TBI and VNG Testing/Management
Research provides some evidence that a large portion of traumatic brain injury TBI - concussional injuries are actually damage to the inner ear or vestibular system. VNG (Videonystagmography) is a functional assessment tool of brain function and balance centers of the nervous system. VNG measures and records the speed and accuracy of eye movements and functions.
Difra VNG Video Demonstration
Pre-Injury Baseline VNG Testing
1. Establish baseline Videonystagmography (VNG) testing for each subject
2. Assess the vestibular system under normal conditions prior to any head injury, TBI or concussion
3. Establish the absence of pre-existing vestibular disorders such as positional vertigo (BPPV), acoustic neuroma and labyrinthine dysfunction
Best choice for concussion - TBI management
NysStar II – Binocular VNG System
2 Cameras, 4 Channel
• Test spontaneous nystagmus, positional and positioning nystagmus, random saccades, optikinetics (OPK) plus gaze nystagmus, active head rotation and calorics
• Video recording and replay of tracking of the eye
• Video goggles with two USB 2.0 digital cameras – resolution of 640 x 480 pixels
• Open-field goggle assembly
• Removable eye cover
• External adjustments for focus and X-Y centering
• Wireless remote control (foot switch remote control available)
Difra NysStar II Binocular VNG• Automatic comprehensive, customizable reports with age-dependent normative data
• Export results over network (intranet or internet) to electronic medical records. All data is stored on the disk and can be archived automatically.
• Multiple levels of password security for doctor, staff and HIPAA compliance -- pro software only
• Reduce downtime--our technical support team can easily remote access your VNG software to troubleshoot and resolve software or hardware issues
• Billable under codes: 92540, 92543 (4 units) and 92546. Refer to our billing and coding page for optional codes.
• Manufactured by Difra Instrumentation -- Difra is a leading global manufacturer of diagnostic balance technology for more than 48 years.
Post-Injury Concussion Management VNG Testing
Inner ear vestibular diagram
1. Compare with a pre-injury VNG analysis to measure severity and long term effects; and reduce the chance of second impact syndrome.
2. If no baseline VNG results are available, conduct VNG testing for post-injury effects on the vestibular system
3. VNG testing provides the data in report form with interpretation by a trained physician
4. Because every concussion is different, treatment protocol will be based on all of the available data: VNG, MRI, CT, etc.
5. VNG tests the vestibular system before the physician releases subject to work or athletics
6. Reduces the risk of second-impact syndrome
7. Measures effectiveness of treatment
Post-Injury Vestibular Rehabilitation Therapy (VRT)
Platform posturography VRT assists with retraining a stable vestibular system to allow the sensory systems of the body to more effectively coordinate their abilities.
VRT is conducted by physical therapists and occupational therapists, including procedures such as Epley, log roll, platform posturography and more. Treatment protocols are individualized and tailored specifically to each person
November, 2017
Which is best for my application, VNG Monocular (one camera, 2 channel) or VNG Binocular (two cameras, 4 channel)?
The primary advantage to binocular recording rather than monocular is that with monocular you can often overlook disconjugate eye movements (i.e., when the eyes are not moving synchronously together).
This would be most common with paralyses of one or more of the extraocular eye muscles or with lesions affecting the medial longitudinal fasiculus which is the major pathway that pairs the eyes together for versional horizontal deviations. Often times you may also have one eye that captures or records poorer than the other such as with individuals who have had prior eye surgeries in which case having dual recording is also more beneficial.
--Troy D. Hale, Au.D, FAAA
--Doctor of Audiology, Asst. Professor ATSU
Athletes and Sports-Related Concussions, TBI, Head Trauma Injuries
Sports related injuries are second only to motor vehicle accidents as the leading cause of traumatic brain injury (TBI), including concussions and head trauma.
Best choice for VNG Concussion Management for Sports Injuries
Sports-related mild concussion has been estimated to account for approx. 300,000 of the 1.54 million mild to moderate TBI’s that occur each year.
Approximately 5.5% of all high school athletic injuries and 6.2% of all collegiate athletic injuries are concussions.
Research has consistently shown that across all sports and ages, females are at a higher risk for sustaining sports-related concussions.
There are ongoing efforts to enact legislation regulating return to play guidelines for sports-related TBI’s.
Symptoms of sports-related concussions and TBI traumatic brain injury / impact injuries
--Headache
--Dizziness/Vertigo
--Confusion, disorientation
--Loss of consciousness
--Nausea and/or vomiting
--Slowed processing speed (slow to respond to questions)
--Slurred or non-sensical speech
--Dyscoordination
--Memory Loss
--Distractibility
--Irritability (feeling more emotional)
--Changes in vision and/or hearing (sensitivity to bright lights or loud noises, blurred vision)
--Anxiety and/or depression
--Fatigue
--Feeling mentally “foggy”
--Numbness or tingling
--Changes in sleep patterns/ difficulty sleeping
Secure Health, Inc. is the exclusive US agent for Difra Instrumentation, a world's leading manufacturer of diagnostic balance disorder technology for more than 48 years.
