Functional loss of the horizontal doll's eye reflex following unilateral vestibular lesions.
The doll's eye reflex represents the vestibulo-ocular reflex (VOR) elicited by high-acceleration head rotation. After complete unilateral vestibular lesions, the ipsilateral, horizontal doll's eye reflex is replaced by a series of "catch-up" saccades. These cause permanent symptoms of blurred vision and dizziness during ipsilateral turns. We compared normal controls and patients with complete surgical lesions or canal paresis of up to 9 years duration via electronystagmography (ENG) to determine the usefulness of the doll's eye test as a diagnostic test for complete vestibular lesions. This test was found to be more sensitive in diagnosis of such lesions than head-shaking nystagmus, rotatory directional preponderance, and spontaneous nystagmus. It is also useful to document VOR function in patients in whom caloric irrigation is contraindicated.
Foster
C A
CA
Division of Head and Neck Surgery, University of California San Diego, La Jolla.
Foster
B D
BD
Spindler
J
J
Harris
J P
JP
D000328:Adult; D000368:Aged; D004584:Electronystagmography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D009760:Nystagmus, Physiologic / Q000502:physiology*; D011182:Postoperative Care; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology*; D012680:Sensitivity and Specificity; D013997:Time Factors; D015837:Vestibular Diseases / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery