Normal Gain of VOR with Refixation Saccades in Patients with Unilateral Vestibulopathy

OBJECTIVE: To characterize the response in the video head-impulse test for the assessment of the vestibulo-ocular reflex (VOR) in patients because of vertigo and dizziness. MATERIALS AND METHODS: After rightward and leftward head impulses, the following results evaluated were: gain of the reflex and appearance of refixation saccades. A particular type of response (normal gain VOR and refixation saccades) was evaluated in a group of patients. RESULTS: In patients with a unilateral abnormality consisting of normal gain and refixation saccades, there was a close concordance with the diseased side and the side to which head impulses elicited the abnormal result. CONCLUSION: In the assessment of patients with dizziness, finding a normal gain VOR with refixation saccades indicates the existence of a peripheral vestibulopathy and localizes to the side of the lesion.