Mueller-Jensen A, Neunzig H P, Emskötter T
J Neurol Neurosurg Psychiatry. 1987 Apr;50(4):389-92. doi: 10.1136/jnnp.50.4.389.
An analysis of oculocephalic response and vestibuloocular reflex (VOR) in 81 patients with coma from various causes showed the importance of reflex eye movements for outcome prediction. Compared with oculocephalic response testing, VOR analysis provided more evidence and allowed more precise study of ocular motility in comatose patients. In 25 patients (31%) without conclusive or with absent oculocephalic response, a preserved VOR could be seen. The results indicated that in all cases with preserved VOR response (independent of the cause of coma) the assumption of a good outcome is justified and was correct in a maximum of 67%. The unpredictability in the other cases was largely due to non-neurological factors. Ninety two per cent of the patients with abolished reflex eye movements died. The combination of absent VOR and abolished pupillary light reaction allows prediction of negative outcome in 100% and shows the paramount importance of these two brainstem reflexes.
对81例各种原因导致昏迷的患者进行的眼前庭反射和前庭眼反射（VOR）分析表明，反射性眼球运动对预后预测具有重要意义。与眼前庭反射测试相比，VOR分析提供了更多证据，并能更精确地研究昏迷患者的眼球运动。在25例（31%）眼前庭反射无定论或缺失的患者中，可以观察到VOR保留。结果表明，在所有VOR反应保留的病例中（无论昏迷原因如何），认为预后良好是合理的，且最多67%是正确的。其他病例的不可预测性主要归因于非神经因素。反射性眼球运动消失的患者中有92%死亡。VOR缺失和瞳孔对光反射消失相结合可100%预测不良预后，这表明这两种脑干反射至关重要。
