Bedside differentiation of vestibular neuritis from central "vestibular pseudoneuritis".
Acute unilateral peripheral and central vestibular lesions can cause similar signs and symptoms, but they require different diagnostics and management. We therefore correlated clinical signs to differentiate vestibular neuritis (40 patients) from central "vestibular pseudoneuritis" (43 patients) in the acute situation with the final diagnosis assessed by neuroimaging. Skew deviation was the only specific but non-sensitive (40%) sign for pseudoneuritis. None of the other isolated signs (head thrust test, saccadic pursuit, gaze evoked nystagmus, subjective visual vertical) were reliable; however, multivariate logistic regression increased their sensitivity and specificity to 92%.
Cnyrim
C D
CD
Department of Neurology, University of Munich, Marchioninistr 15, D-81377 Munich, Germany. christian.cnyrim@charite.de
Newman-Toker
D
D
Karch
C
C
Brandt
T
T
Strupp
Michael
M
D000328:Adult; D000368:Aged; D002544:Cerebral Infarction / Q000150:complications / Q000175:diagnosis; D003937:Diagnosis, Differential; D004584:Electronystagmography; D005260:Female; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis; D009460:Neurologic Examination; D019095:Point-of-Care Systems; D012189:Retrospective Studies; D014717:Vertigo / Q000175:diagnosis / Q000209:etiology; D014724:Vestibular Function Tests; D020338:Vestibular Neuronitis / Q000175:diagnosis* / Q000209:etiology