Why are infrared video Frenzel goggles essential for an accurate BPPV diagnosis?

Why can a bare-eye exam miss BPPV?

Inner ear (peripheral) nystagmus is reduced by visual fixation. A patient looking at the examiner's face in a bright room can hold their eyes steady enough to hide a mild or brief burst. Torsional (rotational) nystagmus is also hard to judge without magnification and recording. Goggles remove both problems¹.

Is video Frenzel testing the same as a VNG?

Not exactly. Videonystagmography (VNG) is a longer test battery, usually performed by audiology or ENT, that includes caloric testing with warm and cool air or water to measure each ear's function. Video Frenzel goggles use similar cameras for bedside positional, head-shaking and spontaneous nystagmus testing. For BPPV, positional testing with goggles is what matters, and when full VNG or caloric testing is needed, we coordinate with your ENT or audiologist.

What do the goggles show in different conditions?

• Posterior canal BPPV: upbeating, torsional nystagmus in the Dix-Hallpike test¹
• Horizontal canal BPPV: direction-changing, side-beating nystagmus in the roll test
• Vestibular neuritis: spontaneous horizontal nystagmus beating away from the affected ear
• Possible central causes: patterns that do not fit, which prompt referral to a physician

Where can I get infrared goggle dizziness testing in Alpharetta or Cumming?

Every dizziness evaluation at our Cumming and Alpharetta clinics includes infrared video goggle testing as part of a 60-minute, one-on-one visit. Patients come from Johns Creek, Roswell, Suwanee and Forsyth County, and we share our findings with your physician.

Where can I get help in Alpharetta, Cumming and nearby?

Dr. Manan Patel, PT, DPT, TPS and our team of physical therapists see patients from Alpharetta, Johns Creek, Milton, Roswell, Cumming, Suwanee, Sugar Hill, Buford, Duluth and Forsyth County at two North Atlanta clinics. Every visit is 60 minutes, one-on-one, and urgent appointments are available within 48 hours. We are in-network with Traditional Medicare, BCBS / Anthem and Tricare, and offer a $129 rate per visit for self-pay and out-of-network plans. Not sure where to start? Take the free symptom self-check, or visit our Alpharetta clinic or Cumming clinic page.

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Related questions

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References

1. von Brevern M, et al. Benign paroxysmal positional vertigo: Diagnostic criteria. Journal of Vestibular Research. 2015.
2. Bhattacharyya N, et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolaryngology–Head and Neck Surgery. 2017.

Answered by Dr. Manan Patel, PT, DPT, TPSDoctor of Physical Therapy, Certified Vestibular Specialist and one of the few certified Therapeutic Pain Specialists in North Atlanta, with 15+ years of outpatient care. About Dr. Patel

This answer is general education, not a diagnosis or a substitute for an examination. If you have new or worsening symptoms, contact your doctor. Call 911 for sudden severe dizziness with trouble speaking, weakness, numbness, double vision or a severe headache.