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Cheap, quick bedside 'eye movement' exam outperforms MRI for diagnosing stroke in patients
Date:9/18/2009

misdiagnose at least a third of them, losing the chance for quick and effective treatment.

"We know that time is brain, so when patients having a stroke are sent home erroneously, the consequences can be really serious, including death or permanent disability," says Jorge C. Kattah, M.D., chairman of neurology at OSF St. Francis Medical Center, who co-led the study.

The study of eye movement tests was suggested by previous research showing that people experiencing a stroke have eye-movement alterations that correlate with stroke-damage to various brain areas and that these are distinct from eye-movement alterations seen with benign ear diseases. Some patients, for example, can't immediately adjust their eye position if their heads are quickly turned to the side, or they experience jerky eye movements as they try to focus on a doctor's finger when looking to either side.

Newman-Toker and his colleagues at the University of Illinois College of Medicine in Peoria wondered whether testing eye movements in dizzy patients might help them sort out which ones were having a stroke from those with other problems.

All of the patients in the current study were seen after complaining of severe dizziness that had lasted for several hours continuously, and all had at least one risk factor for stroke. The researchers selected them to increase the chance that they would find strokes in this population. None of the patients had a history of previous dizzy spells and more than half sought care at the Peoria medical center's ER, though some were inpatients at the hospital or were transferred from other area hospitals.

The researchers gave each patient an exam comprised of three eye-movement tests: looking for inability to keep the eyes stable as patients heads were rotated rapidly to either side, looking for jerkiness as patients tracked a doctor's finger to look right and left, and checking eye position to see if one eye was higher t
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Contact: Christen Brownlee
cbrownlee@jhmi.edu
410-955-7832
Johns Hopkins Medical Institutions
Source:Eurekalert

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