Objective To evaluate the role of eye movement and vestibular function examination in the diagnosis of posterior circulation infarction patients, and provide evidence for clinical diagnosis.
Methods A total of 22 patients of posterior circulation infarction were included in this study, clinical information of the involved patients were collected, including gender, age, initial symptom, hypertension, diabetes, smoking and drinking history, and admission signs. All patients were detected with eye movement examinations (including gaze test, saccade test, smooth pursuit test and optokinetic nystagmus test) and vestibular function examinations (including spontaneous nystagmus, head shaking test and fixation suppression test). The above examinations were recorded using the videonystagmograph.
Results Among 22 patients of posterior circulation infarction, initial symptoms were dizziness/vertigo in 15 cases and limb weakness and numbness in 7 cases. Eye movement examinations showed the abnormality in 19 cases, in which 4 cases by gazes test, 11 cases by saccade test, 15 cases by smooth pursuit test and 12 cases by optokinetic nystagmu test. Vestibular function detection showed that, 22 patients completed the spontaneous nystagmus examination, in which 8 cases were positive (4 cases of cerebellar infarction, 3 cases of pontine infarction, and 1 case of Wallenberg syndrome on the left side and cerebellar hemisphere and vermis infarction on the right side); 17 patients completed the head shaking test, in which 6 cases were positive (2 cases of cerebellum infarction, 2 cases of pontine infarction, 1 case of cerebellar and pontine infarction, and 1 case of Wallenberg syndrome); 19 patients completed the fixation suppression test, in which 8 cases failed in the test (1 case of bilateral cerebellar and pontine infarction, 4 cases of pontine infarction, 2 cases of Wallenberg syndrome, and 1 case of Wallenberg syndrome on the left side and cerebellar hemisphere and vermis infarction on the right side).
Conclusion The cerebellar and medulla oblongata infarction patients often appear dizziness/vertigo as initial symptoms; eye movement detection is helpful for screening posterior circulation infarction; the lesioned hemisphere in patients with cerebellar infarction is consistent with the horizontal component of the spontaneous nystagmus and head shaking; after head shaking test, patients with pontine infarction induced downbeat nystagmus; pontine and medullary infarction patients often fail in the fixation suppression test.
