In the smooth pursuit neck torsion test, what position is the head in when the patient begins tracking a target?

• A. Head rotated 45 degrees
• B. Head in midline
• C. Head rotated 90 degrees
• D. Head flexed forward

Answer: (B)

Beginning with the head in midline provides a neutral baseline for smooth pursuit, with no neck rotation influencing the eye-tracking response. In this test, you first establish normal eye tracking without cervical input, then later introduce neck torsion by rotating the head to see how cervical proprioception alters pursuit. Starting in midline ensures that any changes observed during neck rotation can be attributed to the neck’s input rather than an already rotated or differently positioned head. If the head were already rotated or flexed before tracking, the baseline eye movements would be affected, making it hard to interpret the effect of neck torsion on pursuit.