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Association between leukoaraiosis and saccadic oscillation.

Wu CC, Young YH

Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei.

OBJECTIVE: To use an audiovestibular test battery to evaluate patients with leukoaraiosis in order to investigate the relationship between vertigo and dizziness and leukoaraiosis. DESIGN: Retrospective study. SETTING: Tertiary university hospital. Patients A total of 18 elderly patients with vertigo and dizziness and with leukoaraiosis confirmed by magnetic resonance imaging (hereafter, leukoaraiosis group), and another 18 age- and sex-matched patients with vertigo and dizziness but without leukoaraiosis (hereafter, nonleukoaraiosis group) were enrolled in this study. MAIN OUTCOME MEASURES: Each patient underwent a battery of audiovestibular tests, including audiometry and electronystagmography (ENG). RESULTS: In the leukoaraiosis group, ENG examination showed slow pursuit movements in 72% of patients, slowing of saccadic eye movements in 28%, abnormal optokinetic nystagmus test results in 44%, and canal paresis or caloric areflexia in 56% of cases. Compared with the nonleukoaraiosis group, 50%, 17%, 44%, and 61% of cases exhibited nonsignificant differences in slow pursuit movements, slowing of saccadic eye movements, abnormal optokinetic nystagmus test results, and abnormal caloric test results, respectively. However, saccadic oscillation had an occurrence rate of 72% in the leukoaraiosis group in contrast with a 22% rate in the nonleukoaraiosis group, revealing a significant statistical difference. CONCLUSIONS: Saccadic oscillations in the ENG examination indicated leukoaraiosis on the magnetic resonance imaging scan, with a sensitivity of 72% and a specificity of 78%. We therefore recommend using ENG examination to screen elderly individuals with leukoaraiosis.

Published 20 March 2007 in Arch Otolaryngol Head Neck Surg, 133(3): 245-9.
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