By : Hebatullah Hassan Abass Rozza

Alexandria Faculty of medicine

VOR tests and vertigo

treatment

What is the vestibulo-ocular reflex:

A reflex eye movement that

stabilizes images on the retina during head movement

VOR tests:Caloric test

Head impulse test Head shaking test

Rotation test

Caloric test

head impulse test Vedio

How is it performed ?

??

Head impulse test

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 .

Head shaking test vedio

Head shaking test

How is it performed ?

??

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

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)

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

Rotationary chair test

Vertigo treatment

BPPV :

Meniere disease :

Canalith repositionin

g

1-dietary advice – particularly a low-salt diet . 2-anti vertiginous drugs .Sedatives : diazepam

2

Surgical: decompression of endolymphatic sac .

Labrinthectomy

Vestibular neuritis:

Vestibular rehabilitatio

nCentral vertigo : Treat the cause

Migraine : anti migraine therapy

References http://www.d.umn.edu/~jfitzake/Lectures/DMED/InnerEar/IEPathology/CaloricTest.htmlhttp://www.dizziness-and-balance.com/practice/head-impulse.htmlhttp://www.dizziness-and-balance.com/research/hsn/Head%20Shaking%20Nystagmus.htm