These patients commonly present with complaints of oscillopsia, a sensation of vertical or horizontal motion of the environment, or persistent unsteadiness, especially in the dark. Rotational chair testing is ideal in the assessment of these patients because, unlike caloric testing, higher frequencies are tested and both labyrinths are simultaneously stimulated. This allows for accurate determination of remaining vestibular function, which is important for determining a course of treatment. Thurston et al have shown that gains may be increased in some individuals with cerebellar deficits. However, as patients begin to compensate, the dysfunction becomes less debilitating and noticeable in situations that require complex interaction of the two systems.
Patients can actively promote compensation through a series of rehabilitation exercises.
VOR disturbances are treated with different forms of rehabilitation exercises. Please refer to the Vestibular Rehabilitation chapter for more detail. Changes in the human vestibulo-ocular reflex after loss of peripheral sensitivity. Clinical Neurophysiology of the Vestibular System. Vestibular autorotation testing in patients with benign paroxysmal positional vertigo.