Eye test more accurate than MRI in diagnosing stroke, study suggests

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A one-minute eye-movement exam could be more effective than an MRI when it comes to differentiating between a stroke and other, less serious disorders among individuals experiencing dizziness and nausea, according to the results of a preliminary trial.

Researchers at Johns Hopkins and the University of Illinois conducted a "proof of principle" study to determine if it was possible to outperform an MRI with a bedside exam. Neurologists studied 101 patients who were at heightened risk of stroke due to high blood pressure or high cholesterol, all of who complained of dizziness lasting several hours. Researchers first performed the eye test, which comprised three parts: keeping the eyes stable as the head rotates, jerkiness while following finger movement left to right; and checking eye position to see if one eye appears higher than the other. All patients then underwent an MRI and patients whose eye exams suggested stroke but whose MRIs appeared negative underwent a repeat scan.

At the end of the study, 69 patients had suffered a stroke, 25 had an inner-ear condition and the rest had other neurological problems. The eye test correctly identified all 69 stroke victims, while the MRI identified 61. The remaining eight patients were confirmed during the follow-up MRI exam to have had a stroke. Though the eye test is only in the proof-of-concept phase, researchers said it has the potential to simultaneously reduce costs and improve quality of care. The full study appears in the Sept 17 edition of the journal Stroke.