Teufel, Julian; Strupp, Michael; Linn, Jennifer; Kalla, Roger; Feil, Katharina (2019). Conjugate Eye Deviation in Unilateral Lateral Medullary Infarction. Journal of clinical neurology, 15(2), pp. 228-234. Korean Neurological Association 10.3988/jcn.2019.15.2.228
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Teufel, 2019, Conjugate Eye Deviation in Unilateral Lateral Medullary Infarction.pdf - Published Version Available under License Creative Commons: Attribution-Noncommercial (CC-BY-NC). Download (407kB) | Preview |
BACKGROUND AND PURPOSE
The initial diagnosis of medullary infarction can be challenging since CT and even MRI results in the very acute phase are often negative.
METHODS
A retrospective, observer-blinded study of horizontal conjugate eye deviation was performed in 1) 50 consecutive patients [age 58±15 years (mean±SD), 74% male, National Institutes of Health Stroke Scale 2±1] with acute unilateral lateral medullary infarction as seen in MRI (infarction group), 2) 54 patients with transient brainstem symptoms [transient ischemic attack of brainstem (TIA) group; age 69±16 years, 59% male], and 3) 53 patients (age 59±20 years, 49% male) with diagnoses other than stroke (control group).
RESULTS
Conjugate eye deviation was found in all patients in the infarction group [n=47 (94%) with ipsilesional deviation and n=3 (6%) with contralesional deviation] compared to 41% (n=22) in the brainstem TIA group and 15% (n=8) in the control group (p<0.0001). Within all groups mean deviation and range were similar for both sides (to the right vs. to the left side 26.6°±12.3 vs. 26.1°±12.3 in the infarction group, 10.5°±5.8 vs. 8.4°±6.3 in the brainstem TIA group and 4.5°±3.2 vs. 7.5°±3.2 in the control group). The extent of eye deviation was significantly greater in the infarction group (p<0.05).
CONCLUSIONS
All patients with MRI-demonstrated unilateral medullary infarction showed conjugate eye deviation. Therefore, conjugate eye deviation in patients with suspected acute lateral medullary infarction is a helpful sensitive sign for supporting the diagnosis, particularly if the deviation is >20°.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology |
UniBE Contributor: |
Kalla, Roger |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1738-6586 |
Publisher: |
Korean Neurological Association |
Language: |
English |
Submitter: |
Chantal Kottler |
Date Deposited: |
14 Nov 2019 13:41 |
Last Modified: |
11 Jun 2024 04:11 |
Publisher DOI: |
10.3988/jcn.2019.15.2.228 |
PubMed ID: |
30877695 |
Uncontrolled Keywords: |
cerebral stroke dorsolateral medullary syndrome eye motility disorders neurological examination orthoptics transient ischemic attack |
BORIS DOI: |
10.7892/boris.134826 |
URI: |
https://boris.unibe.ch/id/eprint/134826 |
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