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Vertical conjugate eye deviation in postresuscitation coma
Ken Johkura1, Atsushi Komiyama, Yoshiyuki Kuroiwa
1Department of Neurology, Hiratsuka Kyosai Hospital, Hiratsuka, Yokohama, Japan. jokura-k@kkr.hiratsuke.kanagawa.jp
Annals of Neurology
|November 4, 2004
Summary
Vertical eye deviation is common in hypoxic coma, contrary to prior beliefs. This study found over half of patients exhibited tonic upward or downward eye deviation, indicating widespread brain damage.
Area of Science:
- Neurology
- Neuroscience
- Critical Care Medicine
Background:
- Vertical eye deviation in hypoxic coma is infrequently reported.
- Previous literature suggests this sign is rare.
Purpose of the Study:
- To investigate the incidence and significance of vertical eye deviation in postresuscitation comatose patients.
- To determine the relationship between eye deviation and neurological damage.
Main Methods:
- A consecutive series of 50 postresuscitation comatose patients were observed.
- Incidence of tonic upward or downward eye deviation was recorded.
Main Results:
- Vertical eye deviation was observed in 28 (56.0%) of the 50 patients.
- Both upward and downward deviations were associated with diffuse cerebrocerebellar damage, sparing the brainstem.
- Upward deviation was an early sign, while downward deviation indicated a later transition to a vegetative state.
Conclusions:
- Vertical eye deviation is a frequent finding in hypoxic coma, not rare.
- The presence and type of eye deviation can indicate the extent and prognosis of brain injury.