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

han the other. Each patient then received an early MRI, the highest-quality neuroimaging test available to confirm stroke in dizzy patients. Patients with eye tests suggesting stroke but without stroke on the first MRI scan underwent a repeat scan.

In the end, 69 patients were diagnosed with stroke and 25 with inner-ear conditions. The remainder had other neurological problems. Using only the three eye-movement tests, the researchers had correctly diagnosed all of the strokes and 24 of 25 with inner-ear conditions. By contrast, initial MRI scans were falsely negative in eight of the 69 stroke patients, who were later correctly diagnosed with follow-up MRIs.

Though the researchers emphasize the need to verify their results in a larger and more general population of patients with dizziness, Newman-Toker says the initial findings are "incredibly promising." If they hold true, he adds, testing eye movements could have several advantages over MRI beyond reliable diagnostics. For example, while the wait time for an MRI can be several hours or more, physicians can perform all three eye-movement tests in a minute or less. Also, the eye-movement tests are "basically free," compared to $1000 or more for an MRI, Newman-Toker says.

"In an era where cost containment is butting up against issues of quality in health care delivery, there's tremendous potential for bedside approaches like ours that could reduce costs while improving quality at the same time," says Newman-Toker.


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Contact: Christen Brownlee
cbrownlee@jhmi.edu
410-955-7832
Johns Hopkins Medical Institutions
Source:Eurekalert

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