In bilateral VOR damage, which symptom is described in the notes?

In bilateral VOR damage, which symptom is described in the notes?

• A. Hearing loss
• B. Diplopia
• C. True vertigo
• D. Tinnitus

Answer: (C)

The main idea here is how the vestibulo-ocular reflex (VOR) operates and what happens when it’s impaired on both sides. The VOR stabilizes vision during head movements by driving eyes in the opposite direction of head motion. When both VOR pathways are damaged, the reflex gain drops on both sides, so the eyes don’t compensate properly and vision becomes unstable during movement. That instability can be perceived as movement or spinning, a vertigo sensation, because the brain is receiving conflicting or reduced vestibular input about rotation and orientation. In the notes, this scenario is described as true vertigo, reflecting that vestibular-origin misperception of motion can arise with bilateral VOR disruption. Hearing loss or tinnitus would point to involvement of the cochlea or auditory pathways rather than the VOR system, and diplopia is typically linked to ocular motor or brainstem issues rather than bilateral vestibular loss. So the symptom most aligned with bilateral VOR disruption, as described in the notes, is the vertigo sensation.

The main idea here is how the vestibulo-ocular reflex (VOR) operates and what happens when it’s impaired on both sides. The VOR stabilizes vision during head movements by driving eyes in the opposite direction of head motion. When both VOR pathways are damaged, the reflex gain drops on both sides, so the eyes don’t compensate properly and vision becomes unstable during movement.

That instability can be perceived as movement or spinning, a vertigo sensation, because the brain is receiving conflicting or reduced vestibular input about rotation and orientation. In the notes, this scenario is described as true vertigo, reflecting that vestibular-origin misperception of motion can arise with bilateral VOR disruption.

Hearing loss or tinnitus would point to involvement of the cochlea or auditory pathways rather than the VOR system, and diplopia is typically linked to ocular motor or brainstem issues rather than bilateral vestibular loss. So the symptom most aligned with bilateral VOR disruption, as described in the notes, is the vertigo sensation.