The evaluation of vertigo and the electronystagmogram.

A four-year experience in a Vestibular Clinic led the author to the unconventional opinion that the ENG does not often make a significant contribution in the routine evaluation of patients with vertigo or dizziness. A good history by the doctor is usually enough to make a diagnosis. Audiometry and office ice calorics are done routinely. More sophisticated tests are done if judged necessary. Around 10 per cent of the 300 consecutive cases seen at the clinic had no diagnosis. An ENG on these did not prove to be of help in a diagnosis or getting closer to one. This paper is an invitation to good clinical and synthetic judgement in days when more and more responsibility is delegated to sophisticated equipment.