Cheap, quick bedside 'eye movement' exam outperforms MRI in diagnosing strokes

September 21, 10:30 AMHealth and Science ExaminerP. Elizabeth Anderson

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Cheap, Quick Bedside “Eye Movement” Exam Outperforms MRI

Researchers from Johns Hopkins and the University of Illinois report that a one-minute eye movement exam performed at the bedside of patients complaining of dizziness, nausea, and spinning sensations worked better than an MRI to distinguish new strokes from less serious disorders.

The investigators performed a small study, defined as a “proof of principle” investigation on 101 patients at risk for stroke because of elevated cholesterol or high blood pressure.

“The idea that a bedside exam could outperform a modern neuroimaging test such as MRI is something that most people had given up for dead, but we’ve shown it’s possible,” says David E. Newman-Toker, M.D., Ph.D., assistant professor of neurology at the Johns Hopkins University School of Medicine.

The eye movement test was discovered after stroke victimes were observed to have distinct eye-movements that related to stroke-damage to the brain. For example, they 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. In addition to those movements, researchers also checked eye position to see if one eye was higher than the other.

Using only the three eye-movement tests, the researchers correctly diagnosed all of the strokes and 24 of 25 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.

Given the need to contain medical costs, this is amazing news.  More importantly, in strokes every second lost can mean loss of brain function. Early diagnosis is critical to survival and functioning.  

A patient could wait hours for an MRI, but a bedside test can be done in a matter of minutes. And it’s free, but the time and brain function it could save is priceless.

Source: Johns Hopkins Medicine

More on MRIs here.