Bedside video-oculographic evaluation of eye movements in acute supratentorial stroke patients: A potential biomarker for hemispatial neglect

Kudo, Yoshihisa; Koji, Takahashi; Sugawara, Eriko; Nakamizo, Tomoki; Kuroki, Miho; Higashiyama, Yuichi; Tanaka, Fumiaki; Johkura, Ken

doi:10.1016/j.jns.2021.117442

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…Our data support this finding, as a nonnegligible number of patients had facial palsy, dysarthria, and limb ataxia (Table 4). In addition, we suggest that a more precise examination of oculomotor function (saccades, smooth pursuit, optokinetic nystagmus) could detect the only clinical signs leading to the suspected diagnosis, as demonstrated in recent literature [39].…”

Section: Discussionmentioning

confidence: 78%

Do monosymptomatic stroke patients with dizziness present a vestibular syndrome without nystagmus? An underestimated entity

Nikles,

Kerkeni,

Zamaro

et al. 2023

Euro J of Neurology

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Background and purposeVestibular symptoms are common in emergency department (ED) patients and have various causes, including stroke. Accurate identification of stroke in patients with vestibular symptoms is crucial for timely management. We conducted a prospective cross‐sectional study from 2015 to 2019 to determine stroke prevalence and associated symptoms in ED patients with vestibular symptoms, aiming to improve diagnosis and outcomes.MethodsAs part of the DETECT project, we screened 1647 ED patients with acute vestibular symptoms. Following a retrospective analysis of 961 head and neck magnetic resonance imaging (MRI) scans, we included 122 confirmed stroke cases and assessed them for vestibular signs and symptoms.ResultsStroke prevalence in dizzy patients was 13% (122/961 MRI scans). Most patients (95%) presented with acute vestibular symptoms with or without nystagmus, whereas 5% had episodic vestibular syndrome (EVS). Nystagmus was present in 50% of stroke patients. Eighty percent had a purely posterior circulation stroke, and nystagmus was absent in 46% of these patients. Seven patients (6%) had lesions in both the anterior and posterior circulation. Vertigo was experienced by 52% regardless of territory.ConclusionsA stroke was identified in 13% of ED patients presenting with acute vestibular symptoms. In 5%, it was EVS. Most strokes were in the posterior circulation territory; vertigo occurred with similar frequency in anterior and posterior circulation stroke, and absence of nystagmus was common in both.

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Section: Discussionmentioning

confidence: 78%

Do monosymptomatic stroke patients with dizziness present a vestibular syndrome without nystagmus? An underestimated entity

Nikles,

Kerkeni,

Zamaro

et al. 2023

Euro J of Neurology

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“…Smooth pursuit is also impaired in patients with strokes affecting subcortical regions, including the basal ganglia, the internal capsule, and the thalamus (Lekwuwa and Barnes, 1996). Smooth pursuit is classically impaired ipsilesionally to a supratentorial stroke with contralesional saccade abnormalities (Kudo et al, 2021). Unilateral lesions of the posterior limb of the internal capsule, the basal ganglia, the FEF, and the posterior parietal cortex have all been associated with ipsilesional deficits in smooth pursuit gain (Morrow and Sharpe, 1990;Rivaud et al, 1994;Caplan and van Gijn, 2012).…”

Section: Anterior Circulation Strokes Associated With Abnormal Smooth...mentioning

confidence: 99%

“…In a review of 47 patients with acute unilateral, supratentorial ischemic, and hemorrhagic strokes, patients more commonly had contralesional saccadic deficits than ipsilesional, specifically contralesional saccadic hypometria and reduced saccade latency and velocity were observed (Kudo et al, 2021). The authors found bedside video oculography assessment of the saccade function was a reliable and highly correlated biomarker with hemi-spatial neglect using the behavioral inattention test (Kudo et al, 2021).…”

Section: Anterior Circulation Strokes Associated With Abnormal Saccadesmentioning

confidence: 99%

A review of pursuit and saccadic eye movements and their utility in stroke

Fracica,

Hale,

Gold

2023

Front. Stroke

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The head impulse-nystagmus-test of skew (+ hearing) or HINTS+ exam is a well-established clinical bedside test used in evaluating whether patients with the acute vestibular syndrome have features concerning for a central etiology (e.g., stroke). There are other components of the ocular motor exam that are helpful in the acute setting, including smooth pursuit and saccades. We discuss the anatomy and physiology of the saccade and smooth pursuit pathways from the cortex to the infratentorial region in the context of anterior and posterior circulation strokes in general but with a particular emphasis on distinct vestibular stroke syndromes. For each stroke localization, we review the vascular supply and the expected findings on the HINTS+ exam and correlate this with the expected findings on the smooth pursuit and saccade exams to aid in bedside diagnosis.

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Monocular eye patching modulates ipsilesional reactive saccades and smooth pursuit in patients with left hemispatial neglect

Schenke,

Eling,

Duning

et al. 2023

Brain and Cognition

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Bedside video-oculographic evaluation of eye movements in acute supratentorial stroke patients: A potential biomarker for hemispatial neglect

Cited by 4 publications

References 23 publications

Do monosymptomatic stroke patients with dizziness present a vestibular syndrome without nystagmus? An underestimated entity

Do monosymptomatic stroke patients with dizziness present a vestibular syndrome without nystagmus? An underestimated entity

A review of pursuit and saccadic eye movements and their utility in stroke

Monocular eye patching modulates ipsilesional reactive saccades and smooth pursuit in patients with left hemispatial neglect

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