Neurology Book

Approach

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Oculovestibular Testing

Aka: Oculovestibular Testing, Cold Calorics, Caloric Response
  1. Technique
    1. Patient supine with head at 30 degrees elevation
      1. Isolates input of horizontal semicircular canals
    2. Instill 10-20 ml iced saline into auditory canal
      1. Use 20 cc syringe
      2. Use butterfly tubing with needle cut off
      3. Cools mastoid bone and alters endolymphatic flow
      4. Stimulates vestibular nuclei as if head turned
        1. rapidly to opposite side
  2. Interpretation
    1. Nystagmus both eyes slow toward cold, fast to midline
      1. Not comatose
    2. Both eyes tonically deviate toward cold water
      1. Coma with intact Brainstem
    3. No eye movement
      1. Brainstem injury
    4. Movement only of eye on side of stimulus
      1. Internuclear ophthalmoplegia
      2. Suggests Brainstem structural lesion

Caloric response (C0234172)

Concepts Clinical Attribute (T201)
SnomedCT 22280007
English Caloric response, function, caloric responses (physical finding), caloric responses, Caloric response, Caloric response, function (observable entity), Caloric response (function)
Spanish respuesta calórica (entidad observable), respuesta calórica (función), respuesta calórica
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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