Evaluation of vestibulo-ocular reflex in patients with damage to the central nervous system (GCS score 5-3).

Purpose: The aim of our study was to evaluate the vestibulo-ocular reflex (VOR) in patients with severe damage to the central nervous system (CNS) in the diagnosis of brain death and survival prognosis. Material and methods: The study was conducted in 20 patients with extensive primary central nervous system damage against spontaneous intracranial haemorrhage or craniocerebral trauma and secondary central nervous system damage as a result of cardiac arrest with Glasgow Coma Scale (GCS) score from 3 to 5 treated in the Intensive Care Unit, University Hospital in Bialystok. For labyrinth stimulation we used water at 30 degrees C, recording the reactions with ENG appliance. Records were analyzed in Nathanson-Bergman four-level scale. The first assessment was performed on the second day after the trauma and subsequently the assessments were repeated at 2-day intervals. Results: Of the 20 patients studied, the reflex was recorded in nine, which accounted for 45%. In the remaining 11(55%) patients the reflex was not reported in any test and all of them died. Among patients with recorded VOR, five died and four survived. Conclusions: The results of our study show the usefulness of performing the vestibulo-ocular test in patients with severe brain injury to predict their survival. (C) 2015 Published by Elsevier Urban & Partner Sp. z o.o. on behalf of Medical University of Bialystok.