The non‐paretic‐hand‐to‐opposite‐ear test: A simple test to detect aphasia and neglect and an indicator of large anterior vessel occlusion in patients with suspected acute stroke

Bibliographic Details
Title: The non‐paretic‐hand‐to‐opposite‐ear test: A simple test to detect aphasia and neglect and an indicator of large anterior vessel occlusion in patients with suspected acute stroke
Authors: Matthias L. Herrmann, Clara Franck, Florian F. Schuchardt, Simone Meier, Max Henningsen, Nicole Wimmesberger, Diana Rau, Hans‐Jörg Busch, Christian A. Taschner, Erik Farin‐Glattacker, Jochen Brich
Source: Brain and Behavior, Vol 14, Iss 3, Pp n/a-n/a (2024)
Publisher Information: Wiley, 2024.
Publication Year: 2024
Collection: LCC:Neurosciences. Biological psychiatry. Neuropsychiatry
Subject Terms: aphasia, large vessel occlusion, neglect, paramedic, stroke, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
More Details: Abstract Introduction Aphasia and neglect in combination with hemiparesis are reliable indicators of large anterior vessel occlusion (LAVO). Prehospital identification of these symptoms is generally considered difficult by emergency medical service (EMS) personnel. Therefore, we evaluated the simple non‐paretic‐hand‐to‐opposite‐ear (NPE) test to identify aphasia and neglect with a single test. As the NPE test includes a test for arm paresis, we also evaluated the diagnostic ability of the NPE test to detect LAVO in patients with suspected stroke. Methods In this prospective observational study, we performed the NPE test in 1042 patients with suspected acute stroke between May 2021 and May 2022. We analyzed the correlation between the NPE test and the aphasia/neglect items of the National Institutes of Health Stroke Scale. Additionally, the predictive values of the NPE test for LAVO detection were calculated. Results The NPE test showed a strong, significant correlation with both aphasia and neglect. A positive NPE test result predicted LAVO with a sensitivity of 0.70, a specificity of 0.88, and an accuracy of 0.85. Logistic regression analysis showed an odds ratio of 16.14 (95% confidence interval 10.82–24.44) for predicting LAVO. Conclusion The NPE test is a simple test for the detection of both aphasia and neglect. With its predictive values for LAVO detection being comparable to the results of LAVO scores in the prehospital setting, this simple test might be a promising test for prehospital LAVO detection by EMS personnel. Further prospective prehospital validation is needed.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2162-3279
Relation: https://doaj.org/toc/2162-3279
DOI: 10.1002/brb3.3450
Access URL: https://doaj.org/article/e71ad51b96374061b52cc76d6f25b1a3
Accession Number: edsdoj.71ad51b96374061b52cc76d6f25b1a3
Database: Directory of Open Access Journals
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More Details
ISSN:21623279
DOI:10.1002/brb3.3450
Published in:Brain and Behavior
Language:English