Transcription of NEURO-VESTIBULAR EXAMINATION
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NEURO-VESTIBULAR EXAMINATION
NEURO-VESTIBULAR EXAMINATION David E. Newman-Toker, MD, PhD The Johns Hopkins University School of Medicine Baltimore, MD Syllabus Contents 1. Head Impulse Test (pp 1-3) 2. VOR Cancellation Test (pp 4-6) 3. Dix-Hallpike Test (pp 6-8) 4. Modified Epley Maneuver (pp 9-10) 5. References (pp 11-12) Head Impulse Test ( VOR Gain) What Overview of the Test It has been known for over a century that the eighth cranial nerve conveys balance information to the brain, but until the late 1980s, there was no clinical method available to effectively test for vestibular hypofunction in awake patients at the bedside. For many years, comatose patients had been examined using oculocephalic maneuvers (commonly referred to as doll s eye maneuvers) or caloric testing to interrogate the vestibular system in coarse fashion at the bedside, without the need for special equipment.
Neuro-Vestibular Examination David E. Newman-Toker, MD, PhD Page 2 of 12 The normal VOR response to a rapid, passive head rotation as a subject fixates on a central target is an equal and opposite eye movement that keeps the eyes stationary in space (negative h-HIT).This is sometimes referred
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