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Evaluation of vestibulo-ocular reflex in patients with damage to the central nervous system (GCS score 5-3)
Ireneusz Rzewnicki1, Wojciech Łebkowski2, Justyn Ksawery Kordecki3
1Department of Otolaryngology, University Hospital, Medical University of Bialystok, Bialystok, Poland.
Purpose:
The aim of our study was to evaluate the vestibulo-ocular reflex (VOR) in patients with severe damage to the central nervous system (CNS) in the diagnosis of brain death and survival prognosis.
Material And Methods:
The study was conducted in 20 patients with extensive primary central nervous system damage against spontaneous intracranial haemorrhage or craniocerebral trauma and secondary central nervous system damage as a result of cardiac arrest with Glasgow Coma Scale (GCS) score from 3 to 5 treated in the Intensive Care Unit, University Hospital in Bialystok. For labyrinth stimulation we used water at 30°C, recording the reactions with ENG appliance. Records were analyzed in Nathanson-Bergman four-level scale. The first assessment was performed on the second day after the trauma and subsequently the assessments were repeated at 2-day intervals.
Results:
Of the 20 patients studied, the reflex was recorded in nine, which accounted for 45%. In the remaining 11 (55%) patients the reflex was not reported in any test and all of them died. Among patients with recorded VOR, five died and four survived.
Conclusions:
The results of our study show the usefulness of performing the vestibulo-ocular test in patients with severe brain injury to predict their survival.
