Cervical Ocular Reflex

COR. Yes COR, not a typo for VOR, it stands for Cervical Ocular Reflex. I posted this under ‘Symptoms’ because the state of the COR interrelates with that of the VOR and can affect the eyes. The article’s pretty technical but when it comes down to it the bottom line, in this case quite literally, tells it all

These findings suggest that neck immobility may indeed play a role in the oculomotor disturbances observed in patients with neck complaints

Although MAV’s obviously not a ‘neck complaint’ many people complain of neck stiffness, tightness etc and also because of triggering symptoms people hold their necks stuff and still and it’s those actions that can affect the COR. It’s the slow natural movement of the neck which activates COR. Interestingly it doesn’t respond to fast corrective measures. I admit much of the technicalities are somewhat beyond me but apparently COR activates more in older people and in those with vestibular deficits and can make up for defects in the VOR which can naturally occur as a result of aging. Therefore I thought it’s existence worth noting. It certainly pays to keep the neck moving freely.
https://link.springer.com/article/10.1007/s00221-017-5127-9

This is could also be circular: people with vestibular upset hold their necks stiff to improve their gaze stabilisation. Chicken and egg?

Neck immobility could also impact your eustachian tube clearance process which would have knock on effects to the pressure patterns on your labyrinth …

This area is a minefield.

I’m now waiting for someone to chime in to tell me neck stiffness is a migraine artefact :roll_eyes: :sleeping:

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I’ve found life itself to be much of a minefield. This paper resonated with me because I had a stiff neck from the time mine went chronic together with rear head pressure and the stiff neck never cleared until recent physio and I find now I have a freer neck and now purposefully turn my head periodically on relaxed muscles, many things seem improved. I don’t know about ‘artefact’. For me the stiff neck comes from tight muscles that accompany rear head pressure. It’s certainly chicken n egg situation. People with vestibular conditions hold their heads stiffer and subconsciously restrict head movement, MAVers even more do because head movement can be a trigger, so reading that the COR can be affected by lack of head movement makes sense to me. I also suffer the added disadvantage that Walking outside I tend to pick a point in the distance to walk towards something I was told to do by VRT and which became a habit.

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Exactly

Vigorous side to side movement of VRT could just as easily be:

  1. Clearing the eustachian tube (less vestibular noise at very least)
  2. Reducing neck stiffness
  3. Have similar effect to BPPV physio - imho potentially (temporarily) resolving inner ear pressure due to temporary pressure increase of centrifugal force causing inner ear to release pressure (there is a valve!)

And have nothing to do with compensation! :smiley:

I also think we should be really careful assigning directions of causation where there is admittedly strong association. Something medicine has totally messed up imho due to lack of info, so they go round in circles building causation hypotheses based on associations (holding my hand up here too! :raising_hand_man: but I’m just a pundit)

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Oh I have read that in several articles. It sure can be an indication of a balance dysfunction. Any balance dysfunction I would imagine. Certainly not exclusive to migraine.

I often wonder about all the VRT head turning I was instructed to follow in the past. When I started it 24/7 dizzy I could do it, walking in a straight line up and down turning my head alternately left and right with alternate steps. No problem. Trouble was the aim was eventually this movement was supposed to stop the 24/7 dizziness which it never did. It did eventually stop me being able to perform the movement and I am now just over the last month or so, almost exactly five years later, managing to get it back again consistently. I find the wider and better and more consistently I can do it the better my balance is or rather… It is the other way around … The better my balance is … The wider, and more comfortable performing the movement is. Some days I can do it no problem. Occasionally I veer off. On a bad balance days I don’t even try it. Where the connection to COR might be then who knows?