Retrospective blinded review of magnetic resonance imaging in patients with central electronystagmography findings

Objective: To evaluate the magnetic resonance imaging results (MRI) of pati ents with electronystagmography (ENG) suggestive of central vestibular dysf unction and to determine if MRI abnormalities correlate with ENG findings. Study Design: Retrospective blinded case review. Setting: A regional neurotology center. Patients: Patients with ENG suggesting central vestibular dysfunction were identified (n = 30). An age-matched group of patients with normal ENG resul ts were used as controls (n = 28). Main Outcome Measures: MRI abnormalities in cerebellum, brain stem, cerebellar peduncles, and central ENG findings. Results: Twenty-one patients with abnormal MRI results of the vestibular pa thway were found, 15 with abnormal and 6 with normal ENG results. MRI corre lation with ENG findings has a better predictive value in older patients th an in younger patients. Sixteen patients had MRI evidence of vascular compr ession, seven of whom had abnormal and nine of whom had normal ENG results. Conclusions: This study suggests that a detailed review of MRI images of th e vestibular pathway is warranted, and, in patients with central ENG abnorm alities, MRI may support the diagnosis of central vestibular dysfunction. M RI cannot support central vestibular dysfunction caused by vascular compres sion.