(NaturalNews) If you have severe dizziness and especially if you have hypertension or high cholesterol, it's important to be checked out to see if you are having a stroke. A trip to the emergency room for those kinds of symptoms usually involves a costly, high tech MRI (Magnetic Resonance Imaging). But a new study from stroke researchers at Johns Hopkins and the University of Illinois concludes there may be a better, simpler -- and far cheaper and quicker -- way to distinguish a stroke from other problems that aren't so serious but can also cause dizziness, vertigo and nausea. What's more, the test is all natural. It consists simply of a one-minute eye movement exam performed at the bedside.
The study of 101 patients, all of whom had risk factors for stroke, was just published in the online edition of the journal Stroke. Working in collaboration with colleagues at the University of Illinois in Peoria, Illinois, Johns Hopkins neurologist David E. Newman-Toker, M.D., Ph.D., found that a quick, super cheap exam of patients seen at OSF St. Francis Medical Center in Peoria for dizziness actually caught more strokes than MRIs.
"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," Dr. Newman-Toker, who is assistant professor of neurology at the Johns Hopkins University School of Medicine, said in a statement to the media.
Dizziness is a common problem and sends about 2.6 million Americans to the ER each year, according to Dr. Newman-Toker. The vast majority of these cases are the result of benign inner ear balance problems. However, for about four percent, dizziness is a sign of a stroke or transient ischemic attack (TIA, or "mini-stroke"). Over 50 percent of people who experience dizziness and who are having strokes don't have other classic stroke symptoms such as one-sided weakness, numbness, or speech problems. That's one reason ER doctors misdiagnose at least a third of stroke cases, according to Dr. Newman-Toker.
"We know that time is brain, so when patients having a stroke are sent home erroneously, the consequences can be really serious, including death or permanent disability," Jorge C. Kattah, M.D., chairman of neurology at OSF St. Francis Medical Center and co-leader of the study, said in the press release.
Previous research has shown that people having a stroke have eye movement alterations that correlate with brain areas where stroke damage is occurring -- and these eye movements are distinctly different from alterations seen with benign ear diseases. So Dr. Newman-Toker and his colleagues decided to test eye movements in dizzy patients to document whether they could distinguish which people were having strokes from those with other problems.
The researchers gave each patient in the study an exam made up of three eye movement tests. They looked for the inability to keep the eyes stable as patients heads were rotated rapidly to either side, for jerkiness as patients tracked a doctor's finger to look right and left, and they also checked eye position to see if one eye was higher than the other. Each patient then received an MRI, the so-called "gold standard" neuroimaging test used most often to confirm stroke in dizzy patients.
Patients with eye tests that seemed to indicate stroke but who were not diagnosed by a first, early MRI scan underwent a repeated scan. Over all, 69 patients ended up being diagnosed with stroke and 25 with inner ear conditions. The rest were found to have other neurological problems. Relying only on three eye movement tests, the researchers correctly diagnosed all of the strokes and 24 of 25 with inner ear conditions. On the other hand, initial MRI scans were falsely negative in eight of the 69 stroke patients who were later correctly diagnosed from follow-up MRIs.
If these results hold up in larger studies, testing eye movements could have many advantages over MRIs. For example, the wait for an MRI can be several hours but doctors can perform the three eye movement tests in a minute or less. What's more, the eye test is "basically free," compared to $1000 or more for an MRI, Newman-Toker stated.
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