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1 Approach to the Ocular Motor and Vestibular History and ExaminationHistory and examination of ocular motor and vestibular.Examination
2 AudiometryAudiometry is the measurement of the sensitivity and range of an individual's hearing. As many etiologies of imbalance, nystagmus, vertigo and/or dizziness can have an otologic origin the audiogram is an important piece of information in the evaluation of the dizzy patient. A basic audiogram (Fig. 1...Auditory testing, Audiometry
3 Caloric testingCaloric testing is a peripheral vestibular test which takes advantage of the fact that the labyrinth is sensitive to temperature changes. Warm stimulation causes excitation of the semicircular canals while cold stimulation causes inhibition of the semicircular canals. Caloric testing is performed by...Normal VOR, Abnormal VOR, Vestibular Lab Testing, Calorics
4 ENG, VNG, & VOGElectronystagmography (ENG), and videonystagmography (VNG) or videooculography (VOG) are a collection of tests of eye movements that are performed either using surface electrodes around the eye (ENG) or with video goggles (VNG, VOG) (Figure 1). For all clinical intents and purposes, VNG and VOG ar...Vestibular lab testing, ENG, VNG, & VOG
5 Maddox Rod and Red Glass TestingStrabismus basicsStrabismus, Alignment Normal, Alignment Abnormal
6 Rotary Chair TestingRotary chair testing includes rotation around a vertical axis, and evaluates the horizontal semicircular canal vestibulo-ocular reflex (VOR). The patient sits in a mechanized chair with the head secured in a neutral position or in 30 degree forward flexion (to better isolate the horizontal canals)....Normal VOR, Abnormal VOR, Vestibular Lab Testing, Rotary Chair
7 Semicircular pathwaysOnce the semicircular canal fibers leave the peripheral labyrinth, they synapse in the ipsilateral vestibular nucleus, and then ascend to the ocular motor nuclei. This enables the vestibulo-ocular reflex to respond to head movements in the plane of any canal or combination of canals.Vestibulo-ocular reflex
8 Summary of the most common audio-vestibular testingChart describing common audio-vestibular testing.Vestibular lab testing
9 Vertical semicircular canal pathwaysAnterior Canal Pathway Afferents that originate in the anterior canals (AC) of the peripheral labyrinth first synapse in the ipsilateral vestibular nucleus. Three pathways exist: 1) medial longitudinal fasciculus (MLF) - right AC afferents to right medial vestibular nucleus (MVN), decussate and asc...Anterior Canal Pathway; Posterior Canal Pathway
10 Vertical vergence and fusional amplitudeEssential information on vertical fusional vergences.Normal Alignment, Abnormal Alignment, Fourth Nerve Palsy, Vergence, Fusional Amplitudes
11 Vestibular evoked myogenic potentials (VEMPs)Vestibular-evoked myogenic potentials (VEMP) are electromyographic potential reflex tests that reflect the function of the saccule in cervical VEMP and the utricle in ocular VEMP.1 In the cervical VEMP an inhibitory reflex is evoked from the saccule to the sternocleidomastoid ipsilateral to the stim...Vestibular lab testing, Vestibular Evoked Myogenic Potentials (VEMPs)
12 Video head impulse testingThe video head impulse test (vHIT) is a clinical assessment technique used to assess the function of the semicircular canals-the angular acceleration detectors-which initiate the vestibulo-ocular reflex (VOR). The HIT and vHIT are performed similarly (see assessment of VOR using HIT video LINK), alt...Normal VOR, Abnormal VOR, Vestibular Lab Testing, Video Head Impulse Testing
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