Physiologic nystagmus often fatigues with prolonged eccentric gaze and is of low amplitude. The .gov means its official. Distinct and sustained nystagmus at maximumdeviation 3. Follo the movement of the stimulus with the eyes only. An abnormal test result will reveal the presence of nystagmus in the horizontal and/or vertical channels. 4. anti-dizzy pills. sharing sensitive information, make sure youre on a federal Its not uncommon for a normal patient to have a few beats of jerk nystagmus in lateral gaze. 2017. Depends on functional level b. Saccade testing : Observe the velocity, accuracy and latency of rapid eye movements from one target site to another Helmchen C, Rambold H, Fuhry L, Bttner U. Exp Brain Res. When vertigo accompanies nystagmus and lasts hours to days, the vestibulo-ocular reflex (VOR) may be assessed with the head impulse test (commonly performed by neurologists). Next, the officer will look for . Musculoskeletal exam 7. 6.1.8 Smooth pursuit test . In A the gaze-evoked nystagmus already present at 30 lateral gaze increases at 40 . . *Vertical Nystagmus Yes No Now move the stimulus to the left (suspects right eye) at a speed that would take approximately four seconds for the stimulus to reach the edge of the suspects shoulder. If you believe that yourHorizontal Gaze Nystagmus (HGN) Field Sobriety Test was given incorrectly, or you have questions foran Orange County DUI attorney, contact our firm. In the bilateral peripheral vestibular dysfunction the ratio of the pathological eye-movements was 28% equally with to two methods. The information on this website is for general information purposes only. Whether you have questions about the way in which a horizontal gaze nystagmus test was conducted or just need help figuring out your next steps after being arrested, a legal professional can save you the guesswork and . Pause for . The first procedure is to examine eye movement or extra ocular by the way the patient looks into any room without having to move the head. II. Sinusoidal pursuit is processed with Fourier fits and a Bode plot is produced. a positive test is when there are at least three beats of nystagmus; This test will NOT be positive in patients with a BVL because there is no asymmetry between the two . united health care provider phone number. 1 Kalla R et al. First, check for presence of spontaneous nystagmusophthalmoscopy can make subtle nystagmus easier to appreciate. Check smooth pursuit and saccades. While doing this, the testing Deputy looks for horizontal jerking in the eyes at different positional locations. The smooth-pursuit eye-tracking test is useful in evaluating drug toxicity, central nervous system tumors, . Although most of these patients tend to go directly to the ER, Dr. Gold said, some do show up first in the ophthalmologists office, especially if their vertigo is not severe. Its also important to remember, Dr. Galetta added, that nystagmus is sometimes the only sign of a stroke. Deficits in vertical and torsional eye movements after uni- and bilateral muscimol inactivation of the interstitial nucleus of Cajal of the alert monkey. NOVEL. It was found that the majority (71%) had a combined smooth pursuit and gaze-holding deficit. This means that the eyes shake as they move from side to side. Saccades may be slow (mainly SCAs 1, 2 (severe), and 7), and in severe cases patients lack voluntary saccades, use head thrusts, and have only preserved reflexive eye . The 2 main types of acquired adult nystagmus are jerk, named for its fast corrective phase, and pendular, which has slow back-and-forth phases, said Janet C. Rucker, MD, at NYU Langone Medical Center in New York City. 1. Dr. Eggenberger is professor and vice chairman of neurology at Michigan State University in East Lansing, Mich. Clipboard, Search History, and several other advanced features are temporarily unavailable. Have the patient follow your finger so she/he is looking 30 to the right, left, up, down. Is it a central presentation? (In the vast majority of cases, Dr. Gold added, horizontal jerk vestibular nystagmus will resolve over days or weeks as the brains vestibular system recalibrates.) Note that nystagmus in one eye only is typically an indication of neurological disorders, not intoxication. Horizontal Gaze Nystagmus Test has 3 components Lack of Smooth Pursuit Distinct and Sustained Nystagmus at Maximum Deviation Onset of Nystagmus Prior to 45 degrees Anatomy & Physiology Retina is the photosensitive layer of the eye Fovea is the area of sharp central vision If the eyes do not track equally or the pupils are of different size the person is not a candidate and the test shall not be conducted. Horizontal Gaze Nystagmus (HGN) Field Sobriety Test Administration A patient with no spontaneous nystagmus will produce a tracing that is virtually a straight line. and transmitted securely. Since the smooth pursuit system has its own premotor circuits, a smooth pursuit deficit can be either the result of a premotor smooth pursuit lesion or the consequence of a gaze-holding deficit. The Robustness of the Horizontal Gaze Nystagmus Test: This scholarly article was published in 2007. As noted, medical history and drug-screening blood studies are often essential in evaluating patients with nystagmus. In this phase, the officer is looking for a lack of smooth pursuit. Pattern. Focus on the stimulus until I tell you stop. There are a total of three clues that can be assessed in this test: lack of smooth pursuit, distinct nystagmus at maximum deviation, and the onset of nystagmus prior to 45 degrees. Move at speed taking 4 seconds Check the suspects eyes for the ability to track together. Objective: The aim of the study is to analyze the effects of vestibular spontaneous nystagmus(SN) on the smooth pursuit function of visual ocularmotor system. A unidirectional jerk nystagmus with a positive head impulse test, no skew deviation, and recent acute onset of vertigo suggests a . Eye and physical exam. Dr. Gold recommends taking the following steps: One of the most important things to figure out is whether or not jerk nystagmus is pathologic or even physiologic, said Dr. Galetta. Prior to 45 Degrees Speed of the target is critically in this phase of the HGN test. However, its difficult to confirm the diagnosis without eliciting the typical pattern(s) of nystagmus that would be expected with positional maneuvers, such the as Dix-Hallpike test. Distinct nystagmus will be evident when the eye is held at maximum deviation for a minimum of four seconds. You would likely image and might consider genetic testing, possibly for hereditary ataxias. Unable to load your collection due to an error, Unable to load your delegates due to an error. Bookshelf The most prominent abnormalities consist in fixation instability such as multiple square wave jerks and ocular flutter, which are also complemented by abnormal smooth pursuit, saccadic dysmetria, prolongation of saccade latency, gaze-evoked nystagmus, and impaired VOR. Symptoms. with the smooth pursuit test's 20.3% pathological ratio. PMC Drug treatments to consider include the following. In the present study the eye movements of 30 CN-patients have been studied under static conditions, SPEM, OKN and VORS. 1986 Feb;109 ( Pt 1):81-97 [The significance of directional preponderance in the evaluation of vestibular function in patients with vertigo]. Keep looking at the stimulus until the test is over. 1998 Apr;119(4):436-52. doi: 10.1007/s002210050359. Before Eye movement studies revealed square-wave jerks, gaze paretic nystagmus, rebound nystagmus, impaired smooth pursuit, impaired optokinetic nystagmus, and abnormal fixation [ncbi.nlm.nih.gov] A 51-year-old Chinese man presented with gaze-evoked nystagmus, impaired smooth pursuit and vestibular ocular reflex cancellation, and saccadic dysmetria . . In others, contact around the eyeeither through touch or a contact lenscan achieve the same result. It also tends to have a mixed pattern, said Dr. Eggenberger, such as torsional horizontal or torsional vertical. Before deciding on the type of nystagmus, theres an even more important question, said Daniel Gold, DO, of Johns Hopkins Medicine in Baltimore: Could it be another kind of oscillation? Optokinetic nystagmus : Eye movement response to an optokinetic stimulus . Keep following the stimulus with your eyes until I tell you to stop.. Smooth pursuit tracking is an ocular test used to determine whether there is central pathology that is precluding accurate tracking of . Optokinetic testing and suppression of the vestibulo-ocular reflex by visual fixation are two other ocular motor functions related to smooth pursuit eye movements. Physiological Nystagmus is a natural nystagmus that keeps the sensory cells of the eye from tiring. You perform a pursuit test by following a moving object that can traverse vertical and horizontal eye movements. Disorders of the vestibulo-ocular reflex, optokinetic nystagmus and pursuit movements]. Vestibulo-Ocular Reflex (VOR) Suppression. and transmitted securely. spontaneous nystagmusSN 46SN26Ramsay-Hunt614smooth pursuit testSPTSNSPTSNSNSPTSPSS19.0 46SN3678.3%36/462.68~32.53/s1021.7%10/462.66~16.54/sSN0.50~5.00/s5.01~10.00/s>10.01 /s1430.4%1839.1%1430.4%SNSPTtt=13.338t=6.184t=8.436t=8.477P<0.001SNSNSPTF=9.639P<0.001SNSPTF=1.137P=0.330SNSNSPTr=-0.433P=0.003SNSPTr=-0.061P=0.68746SPT817.4%2145.6%1737.0%SN3.710.69/s7.441.88/s20.045.53/sSNSPTr=0.450P=0.002SNSPTSPT SNSPTSNSN. NHTSA says, Give the suspect appropriate verbal instructions. This type of nystagmus always beats in one direction, said Dr. Galetta. Tests and measures a. When you see it stop and verify that the jerking continues. Lack of smooth pursuit can be caused by a target moved too fast. The spontaneous nystagmus test determines if the patient has any nystagmus, with or without fixation, when sitting with head and eyes in a neutral position. Put feet together, hands at your side. Stand with your feet together, with your hands by your side. Once the tested person is in the in the instructional position the Deputy must qualify the tested individual as a candidate for the test by ensuring that the eyes exhibit equal tracking and have equal pupil size. . Equal Pupil Size Yes No, CLUES: LEFT RIGHT The test begins by the police officer placing the tested person in the instructional stance where the feet are placed together and the arms are kept to the side. Videos link back to NOVEL. Eur J Neurol. Move the stimulus all the way across the suspects face to check the right eye holding that position for a minimum of four seconds. The spontaneous nystagmus test determines if the patient has any nystagmus, with or without fixation, when sitting with head and eyes in a neutral position. Vestibular neuritis causes unidirectional nystagmus in accordance with Alexanders lawthe nystagmus will increase in the direction of the fast phase, said Dr. Gold. [Supranuclear ocular motility disorders. What is the best treatment for nystagmus? Nystagmus test with cervical rotation [edit | edit source] Performance: Evaluate spontaneous nystagmus. 2022 May 12;16:842883. doi: 10.3389/fnhum.2022.842883. The initial movement is a smooth pursuit movement followed by contraversive saccade back to primary gaze or direction of visual interest. The Horizontal Gaze Nystagmus test will not be influenced by optokinetic nystagmus when administered properly. [The analysis of the value ofspontaneous nystagmus in peripheral vestibular hypofunction]. Smooth pursuit can be tested at the bedside by having the patient follow a slowly moving target with both eyes. Dr. Gold is assistant professor of neurology, ophthalmology, neurosurgery, and otolaryngology at Johns Hopkins Medicine in Baltimore, Md. We primarily depend on personal referrals, and so we strive for the highest level of professionalism to earn our clients highest level of respectand theirtop testimonials and reviews. Marti S, Straumann D, Bttner U, Glasauer S. Exp Brain Res. If its right-beating nystagmus, for example, it will increase in intensity when the patient looks to the right. (However, he added, the nystagmus associated with a unilateral central vestibular lesion may also obey Alexanders law.). Reviewed studies provided outcomes on saccadic (n = 12), fixation (n = 3), smooth pursuit (n = 13), and nystagmus (n = 4) eye movements, and there were a plethora of outcomes reported for these eye movements (Table 2, Supplementary Table 1). The stimulus is placed approximately 12-15 inches in front of the individuals face slightly above eyebrow level. Move the stimulus smoothly across the suspects entire field of vision. Thirteen patients (25%) had a smooth pursuit deficit only. Optokinetic nystagmus (OKN) is a physiologic movement of the eyes in response to large, moving visual fields (e.g. To study this question DC eye movement recordings of 52 patients with horizontal gaze-evoked nystagmus and/or smooth pursuit deficits were studied in detail. Hold approx. The first step is checking for Resting Nystagmus, which is the involuntary jerking of the eyes as they are looking straight ahead. 2. sleeping pills. Other specialists might then follow up with a spinal tap or other testing, depending upon what the MRI revealed. 2016;263(suppl 1):24-29. 2015 Jun 30;2(2):75-88. doi: 10.15441/ceem.15.026. The difference of SPT gain in SN fast phase direction between groups with different SN intensity was statistically significant(F=9.639, P<0.001),there was no statistically significant difference in SPT gain between the groups on the SN slow phase direction(F=1.137, P=0.330).The SN intensity significantly negatively correlated with the SPT gain of the fast phase direction of SN (r=-0.433, P=0.003), that was, the SPT gain on the fast phase direction of SN decreased with the increase of SN intensity. This type of nystagmus is generated by vestibular asymmetry, and it can be due to an inhibitory disorder like vestibular neuritis or an excitatory disorder like benign paroxysmal positional vertigo (BPPV), said Dr. Gold. Start moving the stimulus toward the right (suspects left eye) at a speed that would take approximately four seconds for the stimulus to reach the edge of the suspects shoulder. probiotics, prebiotics, and synbiotics definition; apex sharing trailhead The goal of therapy for nystagmus, said Dr. Eggenberger, is to treat the underlying cause, which will often take care of ocular manifestations, especially with many of the peripheral vestibular disorders. Eye movement abnormalities are frequent and include gaze-evoked nystagmus, saccadic dysmetria, square-wave jerks, abnormal smooth pursuit, and inability to suppress the VOR. The corresponding mean values of SN intensity were (3.710.69)/s, (7.441.88)/s, (20.045.53)/s, respectively, without type IV wave. (faster than smooth pursuit) e.g. This course provides an introduction to the CE-Chirp stimulus family, which is found in the Interacoustics Eclipse and Titan platforms. As shown in Fig. Is neuroimaging necessary? In any case, the experts recommend that you refer the patient for any unexplained findings. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 1999 Feb;81(2):668-81. doi: 10.1152/jn.1999.81.2.668. Prediction of Vestibular Imbalance in Acute Peripheral Vestibulopathy by Measuring Horizontal Ocular Deviation on Magnetic Resonance Imaging. Within the vestibular functioning step, oculomotor evaluation should include evaluation of nystagmus, skew, smooth pursuit, saccades, Dix-Hallpike test, static and dynamic visual acuity, and the vestibulo-ocular reflex (VOR) including VOR cancellation and the head thrust test. Ex- ponentially decaying slow phases of nystagmus become obvious with longer intervals between fast phases. government site. However, the upward VOR, optokinetic nystagmus and smooth pursuit gains are superior to the corresponding downward gains in normal subjects, monkeys and cats (Baloh et al., 1983; Matsuo and Cohen, 1984; Ranalli and Sharpe, 1988b; Baloh and Demer, 1991; Tweed et al., 1994; Maruyama et al., 2004). There was no significant correlation between SN intensity and the gain of SPT on the slow phase direction of SN (r=-0.061, P=0.687). On the OLS test, users of all four drug classes were significantly more likely to sway while balancing and use their arms to maintain balance, but . A recent head or neck injury could also dissect a vertebral artery, causing stroke, said Dr. Gold, and severe headache might point to hemorrhage in the posterior fossa. It was found that the majority (71%) had a combined smooth pursuit and gaze-holding deficit. Now move the stimulus all the way to the left, back across suspects face checking if the right eye pursues smoothly. Table 4: Characteristics of gaze-evoked nystagmus of central origin. In a patient with MS, APN may be asymmetric if there is a history of optic neuritis with poor visual recovery in one eye, Dr. Rucker added. But anything that affects normal functioning of the posterior fossa may cause it, such as infection, inflammation, tumor, stroke, or MS.. Federal government websites often end in .gov or .mil. Move the stimulus smoothly, at a speed that requires approximately two seconds to bring the suspects eye as far to the side as it can go. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. when one is looking out the window of a moving train). Then, pin down the origin. Relevant financial disclosures: None. 2018 Feb;39(2):e108-e112. Smooth Pursuit Essay. NHTSA says, After you have checked both eyes for lack of smooth pursuit, check the eyes for distinct nystagmus at maximum deviation beginning with the suspects left eye. *Lack of Smooth Pursuit MR diffusion weighted imaging demonstrated an acute stroke involving the left middle cerebellar peduncle (MCP) and lateral pons . Coordination tests a. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. Optokinetic response movements / postrotatory nystagmus. Check the full list of possible causes and conditions now! Ask about the time of onset and whether the nystagmus is continuous or episodic, as well as about any associated features, said Dr. Eggenberger. 2 seconds out; 2 seconds back when one is looking out the window of a moving train) 6).The initial movement is a smooth pursuit movement followed by contraversive saccade back to primary gaze or direction of visual interest. The presence of spontaneous nystagmus can affect all other VNG tests. Disclaimer, National Library of Medicine This course provides an overview of the basics of performing the auditory steady state response (ASSR) test. Optokinetic Nystagmus. APN may have horizontal, vertical, and/or torsional components, said Dr. Rucker. Experimental data show that loss of the neural integrator also abolishes slow conjugate eye movements, i.e. If they are not, this may indicate a head injury. Factors such as age, stimulus and background conditions, medical conditions, When you see it, stop and verify that the jerking continues. Balance Functional Assessment and Management, 2nd Ed. 1978 Dec 14;226(3):183-99 The third set of four passes is designed to determine whether the person has distinct nystagmus at maximum deviation. A unidirectional jerk nystagmus with a positive head impulse test, no skew deviation, and recent acute onset of vertigo suggests a peripheral vestibular disturbance, said Dr. Gold. Approach to dizziness in the emergency department. It may be challenging to see the patients eyes move quickly in real time and understand what is going on, said Eric Eggenberger, DO, at Michigan State University in East Lansing. A full neuro-ophthalmic exam checks not only acuity but also color perception and visual fields, with a focus on motility, said Dr. Eggenberger. 2017 May 5;31(9):678-681. doi: 10.13201/j.issn.1001-1781.2017.09.007. Prevalence and Characteristics of Physiological Gaze-Evoked and Rebound Nystagmus: Implications for Testing Their Pathological Counterparts. The test consists of the Deputy moving the stimulus horizontally at designated speeds. Gaze-evoked nystagmus often reflects an inability of the brains neural integrator to keep the eye locked in an eccentric position and prevent it from drifting back toward center, said Dr. Eggenberger. nystagmus can produce abnormalities of pendular eye movement [3]. Abnormal smooth pursuit results. Otol Neurotol. What is a positive smooth pursuit test? Common causes. In the scientific study of vision, smooth pursuit describes a type of eye movement in which the eyes remain fixated on a moving object. Spontaneous nystagmus test showing congenital nystagmus. CHECK EQUAL TRACKING & PUPIL SIZE. First, lack of smooth pursuit. It is not a lab/test study like the others. In the study group, the results of SPT and SN test with videonystagmography(VNG) were also reviewed. If theres more than 5 degrees of nystagmus amplitude, however, its likely pathologic. -. If the brainstem is involved, associated central symptoms may include double vision, slurred speech, hemiparesis or hemisensory loss, ataxia, hearing loss, hiccups or hoarseness, or difficulty swallowing, said Dr. Gold. Impaired 'fixation suppression' of horizontal vestibular nystagmus during smooth pursuit: Pathophysiology and clinical implications eCollection 2019. official website and that any information you provide is encrypted . Smooth pursuit is evaluated for symmetry (the difference between rightward and leftward scores) and gain (eye velocity . If the eyes do not track together, or if the pupils are noticeably unequal in size, the chance of medical disorders or injuries causing the nystagmus is present (P. VIII-5, NHTSA SFST student manual, HS 178 R1/02). ONSET OF NYSTAGMUS PRIOR . LACK OF SMOOTH PURSUIT ; DIST. One of the standardized field sobriety tests (FSTs) used by law enforcement for a DUI arrest is the Horizontal Gaze Nystagmus (HGN) Field Sobriety test, often abbreviated as the HGN FST. older patients are the more likely to produce errors during the performance of the task). The main job for the clinician is to determine if the nystagmus is caused by peripheral vestibular disease or by involvement of the brainstem and cerebellar connections, said Steven L. Galetta, also at NYU Langone Medical Center. Next check to see that both pupils are equal in size. Gaze-evoked nystagmus is very common and is elicited only in eccentric gaze, said Dr. Rucker. Hallpike-Dix test a. Careers. The smooth pursuit neck torsion test measures smooth pursuit eye movement with the head / trunk in neutral and when the trunk and neck are rotated relative to a stationary . VOR x 1 Dizziness, nausea, headache. Handb Clin Neurol. Therefore, it is essential to identify the presence of spontaneous nystagmus prior to performing any other VNG tests. The https:// ensures that you are connecting to the By Annie Stuart, Contributing Writer, interviewing Eric Eggenberger, DO, Steven L. Galetta, MD, Daniel Gold, DO, and Janet C. Rucker, MD, Instruction Courses and Skills Transfer Labs, Program Participant and Faculty Guidelines, LEO Continuing Education Recognition Award, What Practices Are Saying About the Registry, Provider Enrollment, Chain and Ownership System (PECOS), Subspecialty/Specialized Interest Society Directory, Subspecialty/Specialized Interest Society Meetings, Minority Ophthalmology Mentoring Campaign, Global Programs and Resources for National Societies, Dr. Richard Mills' Opinions, 2002 to 2016, Neuro-Ophthalmology Virtual Education Library (NOVEL) collection, www.eyerounds.org/tutorials/Nystagmus/index.htm, International Society of Refractive Surgery. Pattern. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. This upward velocity bias suggests that the . tests of saccades, smooth pursuit, opk nystagmus and gaze. Thus a major finding is that each substantial gaze-evoked nystagmus is combined with a smooth pursuit deficit; the two deficits are well correlated (coefficient r = 0.81). Is it a gaze-evoked presentation? Nystagmus is a jerking of the eye or a bouncing eye motion caused by multiple factors. It is one of two ways that visual animals can voluntarily shift gaze, the other being saccadic eye movements. Keep your head still and follow the stimulus with your eyes only. Human subjects use smooth pursuit eye movements to stabilize the retinal image of a continuously moving target. Lack of Smooth Pursuit-Does the eye follow the object smoothly as it moves from the center of the face toward the ear, . An official website of the United States government. The HGN instructions from the manual read as follows: The Horizontal Gaze Nystagmus (HGN) Field Sobriety Test checks your eyes for involuntary jerking as you gaze to the side. Optokinetic nystagmus (OKN) is a physiologic movement of the eyes in response to large, moving visual fields (e.g. Pursuit differs from the vestibulo-ocular reflex, which only occurs during movements of the head and serves to stabilize gaze on a stationary object. Note that those patients who had a release of fixation effect (relatively greater SPV during pursuit) are above the diagonal. To study this question DC eye movement recordings of 52 patients with horizontal gaze-evoked nystagmus and/or smooth pursuit deficits were studied in detail. The next clinical challenge? Case Rep Otolaryngol. Nothing on this site should be taken as legal advice for any individual case or situation. 1. The suppression or complete abolition of nystagmus can be explained by the pursuit system preventing the vestibular system from moving the eyes away from a head-fixed target. The functions of each type of eye movement are introduced here; in subsequent sections, the neural circuitry responsible for three of these types of movements is presented in more detail (see Chapters 14 and 19 for further discussion of neural circuitry . Relevant financial disclosures: None. If found to be qualified, the test is conducted with the Deputy presenting a stimulus for the tested person to fix their vision upon. Spontaneous test showing horizontal left-beating nystagmus. When the neural integrator isnt working and a patient looks to the right, for example, Dr. Gold said, the orbital elastic tissues move the eyes back to center (slow phase of nystagmus), and a rightward fast phase is generated to keep the eyes looking to the right. Eom Eye Test has certain procedures. Introduction. Methods: A total of 46 patients with acute unilateral peripheral vestibular syndrome with SN (26 cases of vestibular neuritis, 6 cases of Ramsay Hunt Syndrome (RHS) with vertigo, 14 cases of sudden deafness with vertigo) were included in this work. This is a video demonstrating the performance of the lack of smooth pursuit portion of the horizontal gaze nystagmus test that is used in DUI investigations.. NHTSA says, Next, check for onset of nystagmus prior to 45 degrees. Smooth pursuit b. Saccadic saccades c. Spontaneous nystagmus d. Gaze evoked nystagmus 5. Watch the eye carefully for any sign of jerking. With the scoring card, the existence of four cues of intoxication is an indication of a driver being above a 0.08% blood alcohol level. . The manual used to train all officers in the United States, the NHTSA manual, contains the instructions and strict testing protocol for this test because it is believed to be strongly correlated with alcohol impairment at or above a .08% blood alcohol level. Copyright 2021 Robert Miller & Associates. This short video tutorial provides an overview of the concept of the auditory steady state response (ASSR) test. Eye movement deficits following ibotenic acid lesions of the nucleus prepositus hypoglossi in monkeys II. Repeating the procedure (P. VIII-7, NHTSA SFST student manual, HS 178 R1/02).
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