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Eye Brain. 2016 Sep 6;8:153-164. doi: 10.2147/EB.S82670. eCollection 2016.

Traumatic brain injury and vestibulo-ocular function: current challenges and future prospects.

Wallace B1,2,3,4, Lifshitz J4,5,6,7,8.

Author information

1
360 Balance and Hearing, Department of Physical Therapy, Austin, TX.
2
Concussion Health, Department of Clinical Education, Austin, TX.
3
Conquering Concussions, Scottsdale, AZ.
4
Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ.
5
Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, AZ.
6
The CACTIS Foundation, Scottsdale.
7
Phoenix VA Healthcare System, Phoenix, AZ.
8
Department of Psychology, Arizona State University, Tempe, AZ, USA.

Abstract

Normal function of the vestibulo-ocular reflex (VOR) coordinates eye movement with head movement, in order to provide clear vision during motion and maintain balance. VOR is generated within the semicircular canals of the inner ear to elicit compensatory eye movements, which maintain stability of images on the fovea during brief, rapid head motion, otherwise known as gaze stability. Normal VOR function is necessary in carrying out activities of daily living (eg, walking and riding in a car) and is of particular importance in higher demand activities (eg, sports-related activities). Disruption or damage in the VOR can result in symptoms such as movement-related dizziness, blurry vision, difficulty maintaining balance with head movements, and even nausea. Dizziness is one of the most common symptoms following traumatic brain injury (TBI) and is considered a risk factor for a prolonged recovery. Assessment of the vestibular system is of particular importance following TBI, in conjunction with oculomotor control, due to the intrinsic neural circuitry that exists between the ocular and vestibular systems. The purpose of this article is to review the physiology of the VOR and the visual-vestibular symptoms associated with TBI and to discuss assessment and treatment guidelines for TBI. Current challenges and future prospects will also be addressed.

KEYWORDS:

concussion; ocular motor; symptoms; traumatic brain injury; vestibular

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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