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Learn how office vestibular examination can predict ENG test results. METHODS: Prospective study completed in one year in a tertiary-care hearing and balance center. The study included 100 patients presenting with dizziness or vertigo who underwent office vestibular examination with Frenzel's glasses or video monitoring and ENG tests. Examination included spontaneous, positional, and vestibular-induced eye movements. Laboratory-based ENG used surface electrodes and standard protocol to acquire and analyze oculomotor and vestibular eye movements. The audiologist was blinded to the physician's a priori prediction of ENG results. Vestibular exam and ENG results were correlated to determine the percentage of correctly predicted results. RESULTS:The predictive sensitivity of vestibular exam was 100% for spontaneous, post-head shake and nonparoxysmal positional nystagmus. The vestibular exam sensitivity for predicting unilateral vestibular hypofunction was 95% compared with caloric results. CONCLUSIONS: Office vestibular examination is highly sensitive in predicting ENG test results in 95% of vestibular patients. Physicians can rely with confidence on office vestibular examination when ENG is not available.