The oculocephalic response in the evaluation of the dizzy patient

Laryngoscope. 1996 Jan;106(1 Pt 1):6-9. doi: 10.1097/00005537-199601000-00002.

Abstract

The oculocephalic response (OCR) is a simple office maneuver that assesses the vestibulo-ocular reflex (VOR). An abnormal response is manifested clinically as refixation saccades following a rapid horizontal head movement. Because little attention has been given to the OCR in the literature, a prospective study was undertaken with 112 consecutive patients who presented with dizziness and underwent OCR testing followed by caloric evaluation. Agreement was good between the OCR and caloric evaluation (kappa = 0.44). Specificity was quite high (97%); sensitivity was found to be less (39%). Positive (68%) and negative (90%) predictive values of the OCR illustrate that the clinician can often anticipate the results of caloric testing based on this response. This easily performed test of the VOR is a useful tool in the evaluation of the dizzy patient.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Caloric Tests
  • Child
  • Dizziness / diagnosis*
  • Female
  • Fixation, Ocular*
  • Head / physiology*
  • Humans
  • Male
  • Methods
  • Middle Aged
  • Movement
  • Prospective Studies
  • Saccades*
  • Sensitivity and Specificity