Prévost sign (eyes)
The Prévost sign, also known as the Vulpian sign, refers to conjugate ocular deviation in patients with acute cortical hemiparetic stroke.
The direction is variable, depending on the location of the stroke 3.
In a hemispheric stroke, the eyes usually deviate towards the lesion (away from the hemiparesis). The degree of deviation may be exaggerated when the head is turned in the same direction. It is most pronounced with non-dominant hemisphere (thus right) lesions 2-3.
Involvement of the thalamus, on the other hand, usually results in conjugate gaze deviation away from the lesion and thus towards the side of hemiparesis 3.
History and etymology
It is named after Jean Louis Prévost, Swiss physician (1838-1927) and Edme Felix Alfred Vulpian (1826 -1887) 4.
- 1. Fruhmann Berger M, Pross RD, Ilg U, Karnath HO. Deviation of eyes and head in acute cerebral stroke. BMC neurology. 6: 23. doi:10.1186/1471-2377-6-23 - Pubmed
- 2. Derakhshan I. How do the eyes move together? New understandings help explain eye deviations in patients with stroke. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. 172 (2): 171-3. doi:10.1503/cmaj.1040322 - Pubmed
- 3. Shoichiro Sato, Masatoshi Koga, Hiroshi Yamagami, Satoshi Okuda, Yasushi Okada, Kazumi Kimura, Yoshiaki Shiokawa, Jyoji Nakagawara, Eisuke Furui, Yasuhiro Hasegawa, Kazuomi Kario, Shoji Arihiro, Kazuyuki Nagatsuka, Kazuo Minematsu, Kazunori Toyoda. Conjugate Eye Deviation in Acute Intracerebral Hemorrhage. Stroke. 43 (11): 2898. doi:10.1161/STROKEAHA.112.666750 - Pubmed
- 4. John M S Pearce. Fragments of Neurological History. ISBN: 9781783261109