Prévost sign (eyes)

Last revised by Rohit Sharma on 4 May 2024

The Prévost sign, also known as the Vulpian sign or eye sign, refers to conjugate eye deviation in patients with acute stroke. The direction is variable, depending on the location of the stroke 3.

In a hemispheric stroke, the eyes deviate ipsilaterally towards the stroke (i.e. contralateral to the hemiparesis), due to involvement of the frontal eye fields. The degree of deviation may be exaggerated when the head is turned in the same direction. Eye deviation is most pronounced with non-dominant hemisphere (usually, right hemisphere) strokes, presumably due to concurrent presence of neglect/extinction 2,3,6

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. This is sometimes known as "wrong-way eyes" 5.

History and etymology

It is named after Jean Louis Prévost, Swiss physician (1838-1927) and Edme Felix Alfred Vulpian (1826 -1887) 4.

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