Measurement of horizontal ocular deviation on magnetic resonance imaging in various disease with acute vertigo

Autoři: Yeon-Jun Yang aff001;  Ji Eun Choi aff001;  Min Tae Kim aff001;  Sang Hyub Kim aff001;  Min Young Lee aff001;  Dong Soo Yoo aff003;  Jae Yun Jung aff001
Působiště autorů: Department of Otorhinolaryngology-Head & Neck Surgery, Dankook University Hospital, Cheon-an, Republic of Korea aff001;  Department of Otorhinolaryngology-Head & Neck Surgery, College of Medicine, Dankook University, Cheon-an, Republic of Korea aff002;  Department of Radiology, College of Medicine, Dankook University, Cheon-an, Republic of Korea aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224605


In our previous study, we found that horizontal ocular deviation (OD) was significantly increased in patients with unilateral vestibular neuritis (VN). This study is aimed to compare the measurements of horizontal OD in various diseases which can present as acute vertigo in the emergency department. We retrospectively reviewed patients who visited the emergency department and underwent brain MRI due to acute vertigo. We compared them to healthy controls who underwent brain MRI for a regular health examination. Among the study participants, 149 patients who were diagnosed with benign paroxysmal positional vertigo (BPPV), unilateral Ménière's disease (MD), vestibular migraine (VM), unilateral vestibular neuritis (VN), or posterior inferior cerebellar artery (PICA) infarction were enrolled. Absolute angles of horizontal OD were larger in the definite MD (19.1 ± 12.7°), possible and probable MD (15.5 ± 11.7°), and VN (22.2 ± 11.7°) groups compared to the control group (4.3 ± 3.7°). Most VN patients (83.3%) had horizontal OD toward the direction of the lesion. About half of the MD patients (46.2%) and half of the patients with PICA infarction (50.0%) had horizontal OD toward the opposite direction of the lesion. Regarding PICA infarction, horizontal OD was observed only in patients who immediately underwent an MRI after developing the PICA territory vestibulocerebellar infarction. Although the exact mechanism of horizontal OD is unclear, this study suggests that horizontal OD reflects a static vestibular imbalance, and that the eyeball is deviated to the weaker of the two vestibular nuclei during neural resting activity. Therefore, horizontal OD could be helpful in assessing for a prior vestibular imbalance.

Klíčová slova:

Critical care and emergency medicine – Eyes – Infarction – Lesions – Magnetic resonance imaging – Migraine – Vertigo – Meniere disease


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2019 Číslo 10