vor allows for parallel gaze. prevents
diplopiaamaconten
Semi circula
R a
a
frontal X
eyefield internal
sending descend via
in hib
contaa
/ capsule
to conlataterat
W
(pons)
1X
contralater
↓
Lesion
Legend
X =
CNVI can't look in
ipsilateral direction
X =VFNULUChton
conlatateral eye adduction >
-
b / no contralateral ( N X
activation
* MLF,CanaddSal
direction when contralateral
dres.
eye
intact
Convergence
.
↓
contralateral eye nystagmus
.
X frontal
eye field; both
=
eyes cant look in contralateral
direction .Eyes drift slowly
↓ direction of lesion .
Nyastag
=
↳ NO ADDUCT +
O PPOSITE
DOLL'S EYE REFLEX COCULOCEPHALIC
REFLEX
·
Application of VOR used No test comatose pts ., neonates, anesthasized pts
dizzy
+ .
, pts
head rotated.
· Pts .
eyes held open +
briskly
· oculocephaliretiex of head (e
stay looking forward)
rotation
=
pt . moves
eyes to
opposite side .
eyes
↳ indicates :
INTALT BRAINSTEM
O reflex pt direction of head rotation
negative oculocephalic : moves
eyes to same
. .
·
↳ indicates brainstene !
:
dysfun
· NOTE :
·
reflexsurpressed in conscious adults
but active in comatics
pr ol goss brainstemfin.
· absent when damaged brainsters/reflex are
(SLOW) &
+
TOWARDS (FAST) IBRAINSTEM
(Srow] &
+ AWAY (FAST)
Vestibubeyondexe is
&
duration =
·
significant
difference btrn warm + hold stimulation
REDUCED
11
It
NORMAL
HYPERACTIVE =
DIRECTION
COLD TOWARDSSLOW) WARM
AWAYISLOT
=
Brainster
·
+ AWAY (FAST) =
Intact + Coma
· Dizziness
Motion sickness
·
·
vertigo (affected semicircular ·Vestibular Schwanomna Low Brainster
canal) more severe CumOr on CNVIEj unilateral) NONE
Lesion + Coma
-
·Benignparymponvegowdipadmu)
a MLFLesion Closest eye FOWARDS (SLOW)
COLD WARM
furtheYANAYCSO
= =
·
Dizziness (Bilateral) +AWAY (FAST)
· Motion sickness
·
nystagmus u/ stimulus (pendular , jerk)
(brainster lesion)
Add Cortical lesion
less severe
vertigo
-
·
-
diplopiaamaconten
Semi circula
R a
a
frontal X
eyefield internal
sending descend via
in hib
contaa
/ capsule
to conlataterat
W
(pons)
1X
contralater
↓
Lesion
Legend
X =
CNVI can't look in
ipsilateral direction
X =VFNULUChton
conlatateral eye adduction >
-
b / no contralateral ( N X
activation
* MLF,CanaddSal
direction when contralateral
dres.
eye
intact
Convergence
.
↓
contralateral eye nystagmus
.
X frontal
eye field; both
=
eyes cant look in contralateral
direction .Eyes drift slowly
↓ direction of lesion .
Nyastag
=
↳ NO ADDUCT +
O PPOSITE
DOLL'S EYE REFLEX COCULOCEPHALIC
REFLEX
·
Application of VOR used No test comatose pts ., neonates, anesthasized pts
dizzy
+ .
, pts
head rotated.
· Pts .
eyes held open +
briskly
· oculocephaliretiex of head (e
stay looking forward)
rotation
=
pt . moves
eyes to
opposite side .
eyes
↳ indicates :
INTALT BRAINSTEM
O reflex pt direction of head rotation
negative oculocephalic : moves
eyes to same
. .
·
↳ indicates brainstene !
:
dysfun
· NOTE :
·
reflexsurpressed in conscious adults
but active in comatics
pr ol goss brainstemfin.
· absent when damaged brainsters/reflex are
(SLOW) &
+
TOWARDS (FAST) IBRAINSTEM
(Srow] &
+ AWAY (FAST)
Vestibubeyondexe is
&
duration =
·
significant
difference btrn warm + hold stimulation
REDUCED
11
It
NORMAL
HYPERACTIVE =
DIRECTION
COLD TOWARDSSLOW) WARM
AWAYISLOT
=
Brainster
·
+ AWAY (FAST) =
Intact + Coma
· Dizziness
Motion sickness
·
·
vertigo (affected semicircular ·Vestibular Schwanomna Low Brainster
canal) more severe CumOr on CNVIEj unilateral) NONE
Lesion + Coma
-
·Benignparymponvegowdipadmu)
a MLFLesion Closest eye FOWARDS (SLOW)
COLD WARM
furtheYANAYCSO
= =
·
Dizziness (Bilateral) +AWAY (FAST)
· Motion sickness
·
nystagmus u/ stimulus (pendular , jerk)
(brainster lesion)
Add Cortical lesion
less severe
vertigo
-
·
-
