Diagnostic value of eye movement and vestibular function tests in patients with posterior circulation infarction

Abstract

Objective: To evaluate the diagnostic value of eye movements and vestibular function tests in PCI patients.

Methods: Thirty-eight PCI patients and 31 patients with unilateral vestibular neuritis (UVN) were enrolled and underwent eye movement tests and vestibular function tests (spontaneous nystagmus [SN], head-shaking nystagmus [HSN]).

Results: The rates of eye movement abnormality were 78.9% and 41.9% in PCI and UVN patients, respectively. The positive rate of SN and HSN were, respectively, 41.2% and 43.8% in cerebellar infarction patients, 33.3% and 66.7% in medullary infarction patients, and 100.0% and 86.2% in UVN patients. The horizontal direction of SN and HSN coincided with the affected side in cerebellar infarction patients, and the healthy side in UVN patients, which coincided with the healthy side and the affected side, respectively in medullary infarction patients. The horizontal direction of HSN was bidirectional nystagmus in 16.0% (4/25) of UVN patients.

Conclusions and significance: Eye movement and vestibular function tests contribute to the early diagnosis of PCI. The horizontal direction of SN and HSN are consistently toward the affected side in cerebellar infarction patients and the healthy side in UVN patients, in contrast to medullary infarction patients, and deserve further investigations.

Chinese abstract

目的：评价PCI患者眼球运动和前庭功能检查的诊断价值。

方法：选入38例PCI患者和31例单侧前庭神经炎（UVN）患者, 并对其进行眼球运动测试和前庭功能检查（自发性眼球震颤[SN], 震颤性眼球震颤[HSN]）。

结果：PCI和UVN患者的眼球运动异常率分别为78.9％和41.9％。小脑梗死患者的SN和HSN阳性率分别为41.2％和43.8％；延髓梗死患者的分别为33.3％和66.7％；UVN患者的分别为10​​0.0％和86.2％。 SN和HSN的水平方向与小脑梗塞患者的患侧和UPVD患者的健康侧一致, 分别与髓质梗死患者的健康侧和患侧相符。 HSN的水平方向为双向性眼球震颤, 占UVN患者的16.5％（4/25）。

结论和意义：眼球运动和前庭功能测试有助于早期诊断PCI。与髓质梗塞患者相反, SN和HSN的水平方向始终朝向小脑梗塞患者的患侧和UVN患者的健康侧。这值得进一步研究。

Keywords:

• Posterior circulation infarction
• vertigo
• eye movement
• nystagmus
• vestibular function

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The study was supported by Aerospace Center Hospital [Grant No. YN201802].