{"title":"Videonystagmoscopy and vestibular assessment in Bascharage","seoTitle":"Videonystagmoscopy and vestibular assessment in Bascharage | PES Luxembourg","metaDescription":"Video observation of nystagmus to complement the vestibular examination and help guide rehabilitation in Bascharage. Informations et rendez-vous au Pôle Éq","content":"**Observing eye movements is an important part of the vestibular examination. At Pôle Equilibre & Santé, in Bascharage, the [Framiscope](https://framiral.fr/web/framiscope/) (Framiral) makes it possible to observe nystagmus when visual fixation can be suppressed or controlled, to guide [vestibular rehabilitation](/bascharage/competence/reeducation-vestibulaire). This tool complements the clinical examination; it does not establish all vestibular diagnoses on its own.**\n\n## Why film the eyes to understand the ear\n\nThe inner ear and the eye muscles are linked. When a semicircular canal dysfunctions, the eye beats. The infrared mask, painless, reveals these beats even in the dark, including while walking thanks to the wireless version. These micro-movements are not visible in a mirror: the camera makes them readable.\n\nThe tests vary: spontaneous nystagmus, ocular pursuits, Head Shaking Test, positional tests (rolling over, Dix-Hallpike). Each profile points towards BPPV (crystals in a canal), a hypofunction (one ear that contributes less), or another mechanism — sometimes central, which then belongs more to the doctor. A full videonystagmography, when performed with a dedicated system, may include other categories of tests; the exact content depends on the equipment and the assessment sought. The Framiscope helps the vestibular physiotherapist: it is not an MRI.\n\n## The manoeuvres that HAS recommends\n\nFor benign paroxysmal positional vertigo — a very frequent cause of brief vertigo when turning over in bed — the Haute Autorité de Santé recommends repositioning manoeuvres (Epley, Semont) rather than interminable sessions. Videonystagmoscopy helps identify the canal concerned and check that the manoeuvre has worked. Beyond two or three well-conducted attempts, the diagnosis is rediscussed.\n\nAmerican recommendations (Bhattacharyya et al., AAO-HNS, 2017) go the same way: manoeuvre first, imaging only if the picture leaves typical BPPV. For peripheral vestibular hypofunction, the clinical practice guideline by Hall et al. (*JOSPT*, 2022) places **vestibular rehabilitation** — habituation, compensation, balance — at the centre. The examination serves to choose these exercises, not to replace them.\n\n## The mask, the tests, the brief vertigo\n\nA quiet room, a light mask fitted. The examination often lasts **20 to 40 minutes** according to the tests. Some can trigger vertigo or nausea for a few seconds to a few minutes: it is unpleasant, it is not pain, and it dissipates. We do not force a test if you are too unwell. The results are explained afterwards; the programme (manoeuvre, habituation, compensation, balance work) follows from them.\n\nThe number of rehabilitation sessions is not that of the VNG examination. BPPV is sometimes settled in one or two manoeuvres. A hypofunction often needs several weeks of exercises, sometimes two to three sessions a week at the start, then autonomy at home.\n\n## Caffeine, alcohol, glasses: the evening before and the morning\n\nIf your physiotherapist asks, avoid **caffeine, alcohol and tobacco** in the preceding hours: they can modify the vestibular response. Mention your medicines (especially sedatives, anti-vertigo drugs that mask the signs), an ear infection, a significant eye problem, recent eye or ear surgery. **Never stop a prescribed medicine without medical advice** or a protocol explicitly validated with the prescriber. Lenses: you will be told if they are removed. Heavy eye make-up can hinder the camera: come rather without make-up around the eyelids.\n\nComfortable clothing for changes of position (no tight skirt if one has to lie down and turn the head). You do not need to be fasting, unless instructed otherwise.\n\n## Driving after provoked vertigo\n\nThis is the most practical question. After tests that have triggered vertigo, **do not take the wheel** as long as unsteadiness or nausea has not disappeared. Have someone accompany you if possible, especially for the first assessment. Public transport or a relative are safer than a journey on the Luxembourg motorway with the world spinning. The next day, most patients resume a normal life; fatigue or sensitivity to rapid movements can last a few hours.\n\nVNG does not replace an ENT or neurological opinion if the vertigo is accompanied by sudden deafness, double vision, weakness on one side, violent headache or speech trouble: that is an emergency, not a physiotherapy appointment.\n\n## From the assessment to the habituation programme\n\nFilming the eyes serves to rehabilitate accurately. Afterwards, it is the exercises — sometimes tedious, often effective — that rewire balance. The mask can also serve for follow-up: is there still nystagmus after the manoeuvre? [Neurological rehabilitation](/bascharage/competence/reeducation-neurologique) takes over if it is more a central disorder or Parkinson’s with falls.\n\n## Frequently asked questions\n\n\nIs it painful?
\n\nNo. Transient vertigo or nausea during a test is possible, and dissipates. This is not a needle, not a current.\n\n \n\n\nHow should I prepare?
\n\nAvoid caffeine, alcohol and tobacco in the preceding hours if you have been asked to. Mention your medicines — without stopping them on your own initiative. An ear infection or an eye problem: say so. Ideally, have someone accompany you for the first examination.\n\n \n\n\nCan I drive on the way out?
\n\nNot if a test has triggered clear vertigo. Wait for the vertigo to dissipate, or have someone take you home. Tell the practice if you come alone: we will adapt the tests.\n\n \n\n\nHow many sessions are needed?
\n\nVNG is an examination, not a package. BPPV can resolve in one to three manoeuvres. Rehabilitation of a hypofunction is counted rather in weeks of exercises. The rhythm is decided after the assessment.\n\n \n\n\nGlasses, lenses, make-up: what should I do?
\n\nBring your glasses. You will be told if the lenses stay. Avoid very heavy eye make-up, which sometimes hinders the infrared camera.\n\n \n\n\nIs it reimbursed?
\n\nVestibular rehabilitation is provided on prescription. Physiotherapy is provided on medical prescription so that it can be reimbursed by the [CNS](https://cns.public.lu/fr/assure/remboursements/prestations-remboursees/prestations-paramedicales/kinesitherapeutes.html). The practice handles the paperwork. Details: [The Consultation](/bascharage/kinesitherapie/consultation-kine).\n\n \n\n\nHow can I book an appointment?
\n\nVia [Doctena](https://fr.doctena.lu/cabinet/Pole_Equilibre_Sante-281318) or on +352 26 65 28 42. Practice at 20B Rue du Bois, 4912 Bascharage — see [Contact & access](/contact).\n\n \n\n## Find out more\n\n- [Nathan Klopp](/bascharage/kinesitherapeute/nathan-klopp) — physiotherapist trained in vestibular rehabilitation\n- [Vestibular rehabilitation](/bascharage/competence/reeducation-vestibulaire)\n- [Neurological rehabilitation](/bascharage/competence/reeducation-neurologique)\n- [The technical platform](/bascharage/equipement)\n\n","image":"https://pes-luxembourg.lu/bascharage/wp-content/uploads/sites/2/2022/12/VideoNystagmoGraphie-1024x341.png"}