Which tests may indicate peripheral vestibular dysfunction?

The indication of peripheral vestibular dysfunction is best assessed through specific tests that evaluate how well the vestibular system functions concerning eye movements and head position. Gaze stability testing and head thrusts directly assess the vestibulo-ocular reflex (VOR), which plays a critical role in maintaining visual stability during head movements.

When performing VOR gaze stability testing, the patient's ability to keep their gaze fixed on a target while moving their head is observed. This requires both the vestibular system to detect movement and the ocular system to compensate for it by keeping the visual target stable. A compromised VOR, often due to peripheral vestibular dysfunction, would lead to difficulty in maintaining this stability, indicating a dysfunction.

Similarly, the head thrust test involves rapidly turning the patient's head to one side while they fixate on a target. In individuals with peripheral vestibular issues, there may be a noticeable catch-up saccade (a corrective eye movement) when the head is turned away from the affected side, further confirming vestibular dysfunction.

Other tests listed, such as smooth pursuits and saccades, visual acuity tests, and head turns when walking, do not focus specifically on the function of the vestibular system and are more general assessments of eye movement, vision