What is the role of vestibulospinal reflex (VSR) exam in the evaluation of dizziness, vertigo, and imbalance?

Updated: Mar 13, 2017
  • Author: Hesham M Samy, MD, PhD; Chief Editor: Robert A Egan, MD  more...
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Answer

The VSR can be examined with Romberg, tandem gait, and Fukuda stepping tests. These tests provide information about the patient’s postural stability when visual and proprioceptive inputs are removed. The experienced physician can observe the patient’s postural stability, limits of stability, and strategy of movement at the limits of stability. Clinical testing of postural stability is qualitative and requires both experience on the part of the examiner and cooperation on the part of the patient.

Ask the patient to run the heel repeatedly from the opposite knee down the shin to the big toe, and look for incoordination. Watch the patient walking, performing tandem gait. The normal gait is characterized by an erect posture, moderately sized steps, and the medial malleoli of the tibia tracing a straight line.


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