Bedside differentiation of vestibular neuritis from central "vestibular pseudoneuritis"
2008; BMJ; Volume: 79; Issue: 4 Linguagem: Inglês
10.1136/jnnp.2007.123596
ISSN1468-330X
AutoresC. Cnyrim, David E. Newman‐Toker, C Karch, T. Brandt, Michael Strupp,
Tópico(s)Ophthalmology and Eye Disorders
ResumoAcute 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%.
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