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Introduction: The vestibulo-ocular reflex (VOR) is an important part of the neurologicalexamination of the patient with coma when determining brainstem function. VOR istested via the oculocephalic reflex (OCR) and the oculovestibular reflex (OVR), or coldcalorics. It has been noted that sedative medications, such as opioids and benzodiazepines,can diminish or abolish the VOR.Methods: We performed a chart review on three patients noted to have absent VOR atinitial neurological assessment as an isolated finding.Results: The three patients ranged in age from 45-74 years. Two patients presented withintentional drug overdoses, whereas the third patient had a complicated course postcardiacsurgery and received sedative drugs. All three patients initially had absent responses toOCR and cold calorics bilaterally. However, all other brainstem functions were normal atthe initial examination. All three patients regained both OCR and OVR within 24 hoursafter sedative medication had been removed.Conclusion: Sedatives may selectively and transiently abolish the VOR, altering theclinical examination; this is to be considered in the examination of a patient with coma. [ABSTRACT FROM AUTHOR]