let's know what does the Vestibuloocular reflex mean , and how to treat vertigo

1. By : Hebatullah Hassan Abass
Rozza
Alexandria Faculty of medicine
VOR tests and
vertigo treatment

2. What is the vestibulo-ocular
reflex:
A reflex eye movement
that stabilizes images on
the retina during head
movement

4. VOR tests:
Caloric test
Head impulse test
Head shaking test
Rotation test

5. Caloric
test

7. head impulse test Vedio
How is it
performed ???
Head impulse test

9. Head impulse test :
-It is a bed side technique used to
diagnose reduction in vestibular
function .
-It’s sensitivity is low , as it needs
more than 50% canal paresis to be
positive
-patients with vestibular hypo
function have a catch up saccade
after the head is thrust to ward the
affected side .

10. Head shaking test vedio
Head shaking test
How is it
performed ???

11. Head shaking test :
-purpose : identify vestibular
dysfunction
-It is highly sensitive in cases of
vestibular hypofunction.
-Head-shaking nystagmus is an
indication of asymmetrical
vestibular function

12. Head shaking test :
Bi lateral vestibular loss : No
nystagmus .
Unilateral vestibular neuritis or
acoustic neuroma : nystagmus
usually beating towards the better
ear which decays for 30 seconds
(first phase nystagmus)

13. This test involves
rotating the subject
in a darkened booth
while eye position
is monitored to
assess the VOR.
Rotationary chair
test

14. Vertigo treatment
BPPV :
Meniere disease :
Canalith
repositioning
1-dietary advice –
particularly a low-salt diet
. 2-anti vertiginous drugs
.
Sedatives : diazepam
Surgical: decompression of
endolymphatic sac .
Labrinthectomy

15. Vestibular
neuritis:
Vestibular
rehabilitation
Central vertigo :
Treat the cause
Migraine : anti
migraine therapy

16. References
http://www.d.umn.edu/~jfitzake/Lectures/DMED/InnerEar/I
EPathology/CaloricTest.html
http://www.dizziness-and-balance.com/practice/head-
impulse.html
http://www.dizziness-and-
balance.com/research/hsn/Head%20Shaking%20Nystagm
us.htm