Bedside differentiation of vestibular neuritis from central "vestibular pseudoneuritis". Issue 4 (14th March 2008)

• Record Type: Journal Article
• Authors: Cnyrim, C D; Newman-Toker, D; Karch, C; Brandt, T; Strupp, Michael
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 79:Issue 4(2008)
• Page Start: 458
• Page End: 460
• Publication Date: 2008-03-14
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.2007.123596
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : 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%.