Revista ORL

Make a submission

VVOR and VORS testing as a tool in the diagnosis of unilateral and bilateral vestibular hypofunction

https://doi.org/10.14201/orl.19337

Abstract

Background: In clinical practice, tests such as the head impulse test paradigm (HIMP) and suppression head impulse paradigm (SHIMP) stimulate high-frequency head movements so the visual and somatosensory system are somehow suppressed. In low frequencies, two tests could be useful tools for vestibular assessment: VVOR (visually enhanced vestibulo-ocular reflex) and VORS (vestibulo-ocular reflex suppression). The aim of this study is to explain the eye movements typically found during VVOR and VORS testing in patients with unilateral and bilateral vestibular hypofunction. Methods: Ten patients with unilateral vestibular hypofunction, two patients with bilateral vestibular hypofunction, and ten patients without vestibular symptoms (control group) were analyzed retrospectively through VVOR and VORS testing in an Otometrics ICS Impulse system. Results: In the VVOR test, patients with unilateral vestibular hypofunction exhibited catch-up saccades beating to the healthy side when moving the head to the affected side, while patients with bilateral vestibular hypofunction exhibited catch-up saccades beating to the opposite side of head movement. In the VORS test, patients with unilateral vestibular hypofunction exhibited catch-up saccades to the healthy side when moving the head to this side, while patients with bilateral vestibular hypofunction did not exhibit catch-up saccades during head movement to either side. Conclusion: Our data suggest that the VVOR and VORS tests yield the same findings as the HIMP and SHIMP tests in unilateral and bilateral vestibular hypofunction, and can contribute to confirming peripheral etiology as well as the affected side.
  • Referencias
  • Cómo citar
  • Del mismo autor
  • Métricas
Gresty M, Leech J. Coordination of the head and eyes in pursuit of predictable and random target motion. Aviat Space Environ Med. 1977;48:741-4.
PMid:302117

Halmagyi GM, Chen L, MacDougall HG, Weber KP, McGarvie LA, Curthoys IS. The Video Head Impulse Test. Front Neurol. 2017;8:258.
https://doi.org/10.3389/fneur.2017.00258
PMid:28649224 PMCid:PMC5465266

Halmagyi GM, Gresty MA. Clinical signs of visual-vestibular interaction. J Neurol Neurosurg Psychiatry. 1979;42:934-9.
https://doi.org/10.1136/jnnp.42.10.934

Kingma H, Van de Berg R. Anatomy, physiology, and physics of the peripheral vestibular system. Handb Clin Neurol. 2016;137:1-16.
https://doi.org/10.1016/B978-0-444-63437-5.00001-7
PMid:27638059

Leigh RJ, Zee DS. The neurology of eye movements. 5th edn. Oxford University Press, Oxford. 2015.
https://doi.org/10.1093/med/9780199969289.001.0001

Macdougall HG, McGarvie LA, Halmagyi GM, Rogers SJ, Manzari L, Burgess AM et al. A new saccadic indicator of peripheral vestibular function based on the video head impulse test. Neurology, 2016;87(4):410-8.
https://doi.org/10.1212/WNL.0000000000002827
PMid:27251884 PMCid:PMC4977115

Weber KP, Aw ST, Todd MJ, McGarvie LA, Curthoys IS, Halmagyi GM. Head Impulse Test in Unilateral Vestibular Loss: Vestibulo-Ocular Reflex and Catch-Up Saccades. Neurology. 2008;70:454-63.
https://doi.org/10.1212/01.wnl.0000299117.48935.2e
PMid:18250290

Wong, AMF. Eye movement disorders. Oxford University Press, Oxford. 2007.
Faria-Ramos, B., Cal, R., Carmona, S., Weber, K. P., & Zuma-Maia, F. (2018). VVOR and VORS testing as a tool in the diagnosis of unilateral and bilateral vestibular hypofunction. Revista ORL, 10(3), 165–169. https://doi.org/10.14201/orl.19337

Downloads

Download data is not yet available.

Author Biography

Konrad P. Weber

,
Konrad P. WeberUniversity Hospital Zürich · Neurology and Ophthalmology
+ −