A simple one-minute beside eye-movement exam worked better than an MRI to distinguish new strokes from less serious disorders in patients complaining of dizziness, nausea and spinning sensations, stroke researchers at Johns Hopkins and the University of Illinois have found.

The exam comprised looking for inability to keep the eyes stable as patients’ heads were rotated rapidly to either side, looking for jerkiness as patients tracked a doctor’s finger to look right and left, and checking eye position to see if one eye was higher than the other.

Because more than half of patients with dizziness who are experiencing strokes show none of the classic stroke symptoms, emergency room physicians are estimated to misdiagnose at least a third of them, losing the chance for quick and effective treatment, says David E. Newman-Toker, M.D., Ph.D., assistant professor of neurology at the Johns Hopkins University School of Medicine and study principal investigator.

Testing eye movements could have several other advantages over MRI. For example, physicians can perform all three eye-movement tests in a minute or less vs. several hours or more for an MRI. Also, the eye-movement tests are “basically free,” compared to $1000 or more for an MRI, Newman-Toker says.

Results of the study of 101 patients , who were already at higher than normal risk of stroke because of factors including high blood pressure or high cholesterol, were published online ahead of print on Sept. 17 in Stroke.

Johns Hopkins News release