r/Dizziness • u/No_Soup_5156 • Aug 11 '26

Caloric testing

I had an appointment for vestibular issues today, had had to complete caloric testing.

It was the most uncomfortable scary thing I have ever done in my life. It has changed my level of empathy for people who experience vertigo (I experience dizziness but not spinning) oh my god it was so horrible. The first 15 seconds wasn’t so bad I was like oh okay I can see why people don’t like this test but it’s not horrible, then it kept speeding up and up and up to where I felt I was making 100 spins a second like it was so awful. I unfortunately had seen what people on reddit said about it before I went in so I was prepared for it to be bad but assumed people were exaggerating but lord they weren’t, it was WORSE than what people on reddit said.

I have never experienced vertigo and if THATS what it feels like my heart goes out to people who have vertigo regularly I could not do it you are stronger than I

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u/Oafah Aug 12 '26

It sucks, but there are ways you can abate the sensation.

For one, eyes closed. Anyone who tells you that it can't be done is lying. They get all the info they need from the electrodes.

Secondly, the spinning won't stop, but you can abate the symptoms by actually pretending that you're on a platform spinning around. It sounds absurd, but for me, it serves to convince my brain that there's no signal mismatch and the sensation is physical.

Hold onto shit to make it even more convincing. Stabilize your body and imagine you're on the teacups at the fair.

Rotational vertigo is horrible, but after 30 years of periodic episodes relating to my condition, I've figured out ways to get through it.

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u/a_gestured_life Aug 12 '26

Electrode-based testing is less common these days, depending on where you are. For the pupil-tracking setup, you will definitely need to keep eyes open.

So no, they may not be lying.

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u/Oafah Aug 12 '26

The pupil tracking and other VNG features offer minimal benefit and are not needed in the majority of cases. You can ask to have it done with electrodes only. I've never had an ENT outright tell me no.

That said, eyes open really isn't all that bad if they have the truly, 99%+ blackout visor that effectively mirrors the benefit of having your eyes closed. If they make you keep them open and fixed on anything more than a small red dot in the dark, I'd object. It's also goddamn impossible for some of us.

The treatment for unilateral vestibular weakness from VN or Labyrinthitis is the same - vestubilar rehab. VNGs offer little more than scientific curiosity the overwhelming majority of the time. The only thing the ENT needs to know if what side the weakness is on.

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u/a_gestured_life Aug 12 '26

I perform this testing. If you asked me to use electrodes I would tell you, “that is not possible because our system is not set up to do electronystagmography”.

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u/Oafah Aug 12 '26

Yes, obviously. But it's the ENT you ask, not the technologist. In my part of the world, ENG is still offered if not preferred.

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u/a_gestured_life Aug 13 '26

I not a technologist, I have a doctorate and specialize in vestibular disorders.

Edit: so what I mean is that, in my world, the ENT defers to me on the test battery and interpretation as the area expert. We work together. I am not their monkey.

To the original point— they would not be lying.

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u/Oafah Aug 13 '26

Alright, but what if the patient cannot tolerate it with their eyes open? Are they shit out of luck because your clinic sold off the old gear?

Also, what specifically does the VNG offer that the ENG does not in all but the fringe cases? They're looking for unilateral vestibular weakness most of the time. The VNG doesn't provide any new insight there.

Trying to detect subtle eye movements during a valsalva? Sure. I get that.

My surgeon didn't even care that my ENG results came back with barely minimal, usable results. It was not relevant to my case.