Video 4.12 Evaluating vestibulo-ocular reflex suppression (VORS) from Neuro-Ophthalmology and Neuro-Otology Textbook
Creator
Daniel R. Gold, DO; David S. Zee MD
Affiliation
(DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland; (DSZ) Departments of Neurology, Ophthalmology, Neuroscience, Otolaryngology - Head & Neck Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
Subject
Vestibulo-ocular Reflex (VOR) Supression; Exam
Description
𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: Deficits in pursuit and vestibulo-ocular reflex (VOR)S usually go together, except when the VOR is absent or markedly diminished in which case there is no VOR to suppress, so that VORS seems better than pursuit. This is an important clue that the VOR is diminished. Instructional ocular motor examination procedures. 𝗡𝗲𝘂𝗿𝗼-𝗼𝗽𝗵𝘁𝗵𝗮𝗹𝗺𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗡𝗲𝘂𝗿𝗼-𝗼𝘁𝗼𝗹𝗼𝗴𝘆 𝗧𝗲𝘅𝘁𝗯𝗼𝗼𝗸 𝗟𝗲𝗴𝗲𝗻𝗱: Impairment in pursuit and VORS are almost always both normal or both abnormal, except when the VOR is absent or markedly diminished in which case there is no VOR to suppress, so that VORS appears more normal than pursuit. When this is the case, consider conditions that cause both cerebellar impairment (i.e., saccadic smooth pursuit) and vestibular loss (i.e., the same patient can have normal/near normalappearing VORS, also with an abnormal head impulse test) such as cerebellar ataxia, neuropathy, vestibular arefexia syndrome (CANVAS). https:// collections.lib.utah.edu/ark:/87278/s6bw0r9q
