ArticleNeurology2021
Stroke Prediction Based on the Spontaneous Nystagmus Suppression Test in Dizzy Patients: A Diagnostic Accuracy Study.
Article in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- The epidemiology and clinical presentation of acute vestibular syndromes: a systematic review of the literature.Journal of neurology · 2026Pooled it
- Impact of Clinician Training Background and Stroke Location on Bedside Diagnostic Test Accuracy in the Acute Vestibular Syndrome - A Meta-Analysis.Annals of neurology · 2023Pooled it
- Systematic review and meta-analysis of the diagnostic accuracy of spontaneous nystagmus patterns in acute vestibular syndrome.Frontiers in neurology · 2023Pooled it
- Separating stroke and acute unilateral vestibulopathy using history, examination and vestibular tests: a machine learning approach.Journal of neurology · 2026Article
- Nystagmus phenotypes in posterior circulation stroke.Frontiers in neurology · 2026Article
- Accuracy of First-Line Tests for Posterior Circulation Stroke in the Emergency Department: A Scoping Review.Cureus · 2025Review
- Usefulness of Nystagmus Patterns in Distinguishing Peripheral From Central Acute Vestibular Syndromes at the Bedside: A Critical Review.Journal of clinical neurology (Seoul, Korea) · 2025Review
- Fixational upbeat nystagmus: report of two cases and literature review.Journal of neurology · 2025Article
- Visual Fixation of Skull-Vibration-Induced Nystagmus in Patients with Peripheral Vestibulopathy.Audiology research · 2024Article
- Clinical Assessment of the Nystagmus Fixation Suppression Test: An Experimental Study.The journal of international advanced otology · 2024Article
- The acute vestibular syndrome: prevalence of new hearing loss and its diagnostic value.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2024Article
- Quantifying Induced Nystagmus Using a Smartphone Eye Tracking Application (EyePhone).Journal of the American Heart Association · 2024Article
- Do monosymptomatic stroke patients with dizziness present a vestibular syndrome without nystagmus? An underestimated entity.European journal of neurology · 2024Article
- The value of postcontrast delayed 3D fluid-attenuated inversion recovery MRI in the diagnosis of unilateral peripheral vestibular dysfunction.Quantitative imaging in medicine and surgery · 2023Article
- Article
- Weak nystagmus in the dark persists for months after acute unilateral vestibular loss.Frontiers in neurology · 2023Article
- Effect of convergence on the horizontal VOR in normal subjects and patients with peripheral and central vestibulopathy.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Article
- Nystagmus only with fixation in the light: a rare central sign due to cerebellar malfunction.Journal of neurology · 2022Article
- Automated alternate cover test for 'HINTS' assessment: a validation study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2022Article
- Current concepts in acute vestibular syndrome and video-oculography.Current opinion in neurology · 2022Review
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveFailure of fixation suppression of spontaneous nystagmus is sometimes seen in patients with vestibular strokes involving the cerebellum or brainstem; however, the accuracy of this test for the discrimination between peripheral and central causes in patients with an acute vestibular syndrome (AVS) is unknown.
methodsPatients with AVS were screened and recruited (convenience sample) as part of a prospective cross-sectional study in the emergency department between 2015 and 2020. All patients received neuroimaging, which served as a reference standard. We recorded fixation suppression with video-oculography (VOG) for forward, right, and left gaze. The ocular fixation index (OFI) and the spontaneous nystagmus slow velocity reduction was calculated.
resultsWe screened 1,646 patients reporting dizziness in the emergency department and tested for spontaneous nystagmus in 148 patients with AVS. We analyzed 56 patients with a diagnosed acute unilateral vestibulopathy (vestibular neuritis) and 28 patients with a confirmed stroke. There was a complete nystagmus fixation suppression in 49.5% of patients with AVS, in 40% of patients with vestibular neuritis, and in 62.5% of patients with vestibular strokes. OFI scores had no predictive value for detecting strokes; however, a nystagmus reduction of less than 2 °/s showed a high accuracy of 76.9% (confidence interval 0.59-0.89) with a sensitivity of 62.2% and specificity of 84.8% in detecting strokes.
conclusionsThe presence of fixation suppression does not rule out a central lesion. The magnitude of suppression was lower compared to patients with vestibular neuritis. The nystagmus suppression test predicts vestibular strokes accurately provided that eye movements are recorded with VOG. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that in patients with an AVS, decreased fixation suppression recorded with VOG occurred more often in stroke (76.9%) than in vestibular neuritis (37.8%).
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