The oculocephalic response in the evaluation of the dizzy patient.
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.
Harvey
S A
SA
Department of Otolaryngology and Human Communication, Medical College of Wisconsin, Milwaukee, USA.
Wood
D J
DJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002150:Caloric Tests; D002648:Child; D004244:Dizziness / Q000175:diagnosis*; D005260:Female; D005403:Fixation, Ocular; D006257:Head / Q000502:physiology*; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D009068:Movement; D011446:Prospective Studies; D012438:Saccades; D012680:Sensitivity and Specificity