Conjugate Eye Deviation in Unilateral Lateral Medullary Infarction.
cerebral stroke
dorsolateral medullary syndrome
eye motility disorders
neurological examination
orthoptics
transient ischemic attack
Journal
Journal of clinical neurology (Seoul, Korea)
ISSN: 1738-6586
Titre abrégé: J Clin Neurol
Pays: Korea (South)
ID NLM: 101252374
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
10
10
2018
revised:
02
12
2018
accepted:
03
12
2018
pubmed:
17
3
2019
medline:
17
3
2019
entrez:
17
3
2019
Statut:
ppublish
Résumé
The initial diagnosis of medullary infarction can be challenging since CT and even MRI results in the very acute phase are often negative. 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). Conjugate eye deviation was found in all patients in the infarction group [ 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°.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
The initial diagnosis of medullary infarction can be challenging since CT and even MRI results in the very acute phase are often negative.
METHODS
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
RESULTS
Conjugate eye deviation was found in all patients in the infarction group [
CONCLUSIONS
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°.
Identifiants
pubmed: 30877695
doi: 10.3988/jcn.2019.15.2.228
pii: 15.e9
pmc: PMC6444143
doi:
Types de publication
Journal Article
Langues
eng
Pagination
228-234Informations de copyright
Copyright © 2019 Korean Neurological Association.
Déclaration de conflit d'intérêts
The authors have no financial conflicts of interest.
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