Dysfunction of vestibulo-ocular reflex in infants and toddlers

To investigate the occurrence of functional loss in the vestibulo-ocular reflex (VOR) among young children with vestibular/balance concerns and/or hearing loss.

Retrospective review of 320 children, aged 3 years or under, who underwent rotary chair testing in our pediatric vestibular program. Demographic data, medical diagnosis/findings, and vestibular testing results were documented. Rotary chair outcome was used to determine the functional status of the VOR.

The mean age of these children, 165 girls and 155 boys, was 1.9 years (SD = 0.9). Among these 320 children, 158 patients (49 %) had abnormal VOR findings. There were 40 cases in which video goggles could be properly fitted for recording VOR responses and 28 patients (70 %) had abnormal findings. Observational camera was used in the other 280 patients and 130 of them (46 %) had abnormal VOR findings. Probable causes of abnormal VOR included inner ear malformations, infectious diseases, neurologic involvements and genetic conditions, etc. CONCLUSIONS: Dysfunction of VOR is significant in young children with vestibular/balance concerns and/or hearing loss. While video goggles are ideal for recording VOR responses in the rotary chair, the observational camera approach is effective for younger children who cannot wear video goggles. The outcomes of rotary chair testing can help clinicians to identify possible vestibular pathologies and recommend proper management.