From the Guidelines
A positive Oculocephalic reflex, also known as "doll's eye" reflex, is a neurological sign indicating intact brainstem function, where the eyes move in the direction opposite to the rotation of the head 1.
Key Characteristics
- The eyes will deviate laterally when the head is turned to the same side
- Then return to midline when the head is rotated back to the neutral position This reflex is typically assessed in comatose patients to evaluate the integrity of the brainstem, and its presence suggests that the patient has not suffered significant brainstem injury 1.
Assessment Method
The "doll's eye" test is performed by turning the head from side to side with the head tilted forward 30°, if the eyes do not passively follow the rotating head without a lag, the oculocephalic reflex is considered present 1.
Clinical Significance
The presence of a positive oculocephalic reflex is an important indicator of brainstem function and can help guide clinical decision-making in patients with suspected brain injury or coma 1.
From the Research
Definition of Oculocephalic Reflex
The oculocephalic reflex, also known as the doll's eyes reflex, is a reflex that tests the integrity of the vestibulo-ocular system [(2,3,4,5)]. It is elicited by passive head movement, which causes the eyes to move in the opposite direction of the head movement.
Positive Oculocephalic Reflex
A positive oculocephalic reflex is characterized by the presence of this reflex, indicating that the vestibulo-ocular system is intact [(2,4)]. However, a positive doll's eyes sign might be induced by other defects, and the purpose of some studies is to describe new ocular signs of cortical dysfunction 2.
Clinical Significance
The oculocephalic reflex is an important clinical sign in neurology, as it can help diagnose and localize lesions in the brainstem and vestibular system [(3,5)]. It can also be used to assess the level of consciousness and brain function in comatose patients [(3,4)].
Key Points
- The oculocephalic reflex is a reflex that tests the integrity of the vestibulo-ocular system [(2,3,4,5)].
- A positive oculocephalic reflex indicates that the vestibulo-ocular system is intact [(2,4)].
- The reflex can be used to diagnose and localize lesions in the brainstem and vestibular system [(3,5)].
- It can also be used to assess the level of consciousness and brain function in comatose patients [(3,4)].