The oculocephalic response in the evaluation of the dizzy patient

The oculocephalic response (OCR) is a simple office maneuver that assesses the vestibule-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 (K = 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.