Eng vng instruction form

Dear Patient:
ENG/VNG (electronystagmography) (testing takes approximately 60 minutes)
1. IMPORTANT INFORMATION: Accurate inner ear function testing requires any
medications that act on your central nervous system (CNS) or that suppress you
inner ear function to be stopped a full 48 hours prior to the testing appointment.
This would include any medications you take for dizziness, including Antivert,
Meclizine, Valium, Dramamine, or scopolamine patches. If you forget and take any of
the above medications in the 48 hours prior to your testing appointment, we will be
unable to perform your test and we will need to reschedule your appointment in order
to obtain reliable results.

2. Other CNS acting medications that need to be stopped 48 hours prior to your
appointment would include, but are not limited to: Anti-depressants (Zoloft, Prozac,
Wellbutrin), sleeping pills, tranquilizers, anti-anxiety medications, sedatives,
prescription pain killers that contain narcotics (Tylenol #3, etc.), any cold or allergy
medications that make you sleepy such as Benadryl, Nyquil etc. However, some
medications should not be stopped abruptly. Please check with your
pharmacist or the physician who wrote the prescription with any questions or
concerns regarding stopping these medications. If your physician does not
want you to stop any of the meds mentioned in this paragraph, please let the
clinic know when you present for your appointment.

3. Do not drink alcohol for 48 hours prior to this appointment. (includes hard liquor,

Continue anything you take for heart or kidney problems, high blood pressure, circulatory disorders, blood thinners, breathing disorders, diabetes, cancer, arthritis (non-narcotics), seizures, or hormone imbalance. You may also continue vitamins, steroids, antibiotics, water pills (diuretics). You may take over-the-counter painkillers such as Tylenol, Advil, ibuprofen, aspirin, and acetaminophen etc.
5. We ask that you try not to eat approximately two hours prior to the test. Part of the
test can make you briefly dizzy and may cause nausea. If you need to eat in the two hours prior to testing, please keep the meal light. Keep liquids to a minimum as well.
6. Please do not wear contact lenses. ENG/VNG testing requires measurement of eye
movements and contact lenses interfere with accurate recordings. If you wear your contacts to the appointment, please bring your lens case.
7. Please do not wear ANY eye make-up and make sure any residual eye make-up is
completely removed. Also, we would prefer that you have little to no make-up on your
face, so please wear a minimal amount of moisturizer, cream, lotion, or
foundation make-up
. Face powder is okay.
8. Some patients experience slightly increased symptoms of dizziness after testing and you may wish to have someone available to drive you home.

Please cal us if you have any questions or need to schedule, reschedule or cancel an
appointment: (520) 777-0495.

Please give at least 48 hours notice if you must cancel or reschedule your test.
There is a $50.00 fee for any appointment that is canceled or missed without a 48
hour notice.

Source: http://www.tucsonent.com/images/Forms/English_VNG_Instruction_Form.pdf

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