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Chapter 02

The Oculomotor Battery

Before any vestibular stimulus is applied, you must rule out a broken oculomotor system. These four tests probe the cortex, brainstem, and cerebellum — and they do it in under five minutes.

Figure 2 — Live tracing · Saccades · Normal
+20°0−20°RLTARGETEYETIME →PATIENT VIEW
What's being tested

Rapid, ballistic eye movements that re-fixate the fovea on a new target. Three parameters are analyzed: accuracy, velocity, and latency.

Normal findings

Accuracy: within ~5% of target · Velocity: scales with amplitude (main sequence), peak ~400°/s for 20° saccade · Latency: 200–250 ms.

When it's abnormal

Hypometric (undershoot, shaded in the trace) → cerebellar / basal ganglia · Slow saccades → brainstem (PPRF, MLF — internuclear ophthalmoplegia), white-matter disease, sedation · Increased latency → cortical or attentional deficit. Use a pseudorandomized target paradigm to defeat anticipation.

← Previous · Ch. 01
Anatomy & Physiology
The vestibular labyrinth, hair cells, and the VOR
Next · Ch. 03
Positional & Dix–Hallpike
BPPV variants and canal mechanics
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Concept & Design
Dr. Prahlada N. B
Champions Educational and Medical Society (R)
& Amogh Foundation