Separating posterior-circulation stroke from vestibular neuritis with quantitative vestibular testing
Copyright © 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved..
OBJECTIVE: To separate vestibular neuritis (VN) from posteriorcirculation stroke (PCS) using quantitative tests of canal and otolith function.
METHODS: Video Head-Impulse tests (vHIT) were used to assess all three semicircular canal pairs; vestibulo-ocular reflex (VOR) gain and saccade metrics were examined. Cervical and ocular-Vestibular-Evoked Myogenic Potentials (c- and oVEMP) and Subjective Visual Horizontal (SVH) were used to assess otolith function.
RESULTS: For controls (n = 40), PCS (n = 22), and VN (n = 22), mean horizontal-canal VOR-gains were 0.96 ± 0.1, 0.85 ± 0.3 and 0.40 ± 0.2, refixation-saccade prevalence was 71.9 ± 41, 90.7 ± 57, 209.2 ± 62 per 100 impulses and cumulative-saccade amplitudes were 0.9 ± 0.4°, 2.4 ± 2.2°, 8.0 ± 3.5°. Abnormality-rates for cVEMP, oVEMP and SVH were 38%, 9%, 72% for PCS, and 43%, 50%, 91% for VN. A gain ≤0.68, refixation-saccade prevalence of ≥135% and cumulative-saccade amplitudes ≥5.3° separated VN from PCS with sensitivities of 95.5%, 95.5%, and 81.8%, and specificities of 68.2%, 86.4% and 95.5%. VOR-gain and saccade prevalence when combined, separated VN from PCS with a sensitivity and specificity of 90.9%. Abnormal oVEMP asymmetry-ratios were of low sensitivity (50%) but high specificity (90.9%) for separating VN from PCS.
CONCLUSION: vHIT provided the best separation of VN from PCS. VOR-gain, refixation-saccade prevalence and amplitude were effective discriminators of VN from PCS.
SIGNIFICANCE: vHIT and oVEMP could assist early identification of the aetiology of Acute Vestibular Syndrome in the Emergency Room.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:131 |
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| Enthalten in: |
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology - 131(2020), 8 vom: 28. Aug., Seite 2047-2055 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Calic, Zeljka [VerfasserIn] |
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| Links: |
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| Themen: |
Acute vestibular syndrome |
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| Anmerkungen: |
Date Completed 19.05.2021 Date Revised 19.05.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.clinph.2020.04.173 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM311790283 |
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| 100 | 1 | |a Calic, Zeljka |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Separating posterior-circulation stroke from vestibular neuritis with quantitative vestibular testing |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 19.05.2021 | ||
| 500 | |a Date Revised 19.05.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a OBJECTIVE: To separate vestibular neuritis (VN) from posteriorcirculation stroke (PCS) using quantitative tests of canal and otolith function | ||
| 520 | |a METHODS: Video Head-Impulse tests (vHIT) were used to assess all three semicircular canal pairs; vestibulo-ocular reflex (VOR) gain and saccade metrics were examined. Cervical and ocular-Vestibular-Evoked Myogenic Potentials (c- and oVEMP) and Subjective Visual Horizontal (SVH) were used to assess otolith function | ||
| 520 | |a RESULTS: For controls (n = 40), PCS (n = 22), and VN (n = 22), mean horizontal-canal VOR-gains were 0.96 ± 0.1, 0.85 ± 0.3 and 0.40 ± 0.2, refixation-saccade prevalence was 71.9 ± 41, 90.7 ± 57, 209.2 ± 62 per 100 impulses and cumulative-saccade amplitudes were 0.9 ± 0.4°, 2.4 ± 2.2°, 8.0 ± 3.5°. Abnormality-rates for cVEMP, oVEMP and SVH were 38%, 9%, 72% for PCS, and 43%, 50%, 91% for VN. A gain ≤0.68, refixation-saccade prevalence of ≥135% and cumulative-saccade amplitudes ≥5.3° separated VN from PCS with sensitivities of 95.5%, 95.5%, and 81.8%, and specificities of 68.2%, 86.4% and 95.5%. VOR-gain and saccade prevalence when combined, separated VN from PCS with a sensitivity and specificity of 90.9%. Abnormal oVEMP asymmetry-ratios were of low sensitivity (50%) but high specificity (90.9%) for separating VN from PCS | ||
| 520 | |a CONCLUSION: vHIT provided the best separation of VN from PCS. VOR-gain, refixation-saccade prevalence and amplitude were effective discriminators of VN from PCS | ||
| 520 | |a SIGNIFICANCE: vHIT and oVEMP could assist early identification of the aetiology of Acute Vestibular Syndrome in the Emergency Room | ||
| 650 | 4 | |a Evaluation Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Acute vestibular syndrome | |
| 650 | 4 | |a Posterior circulation stroke | |
| 650 | 4 | |a Saccades | |
| 650 | 4 | |a Vestibular neuritis | |
| 650 | 4 | |a Vestibulo-ocular reflex | |
| 650 | 4 | |a Video head impulse test | |
| 700 | 1 | |a Nham, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Bradshaw, Andrew P |e verfasserin |4 aut | |
| 700 | 1 | |a Young, Allison S |e verfasserin |4 aut | |
| 700 | 1 | |a Bhaskar, Sonu |e verfasserin |4 aut | |
| 700 | 1 | |a D'Souza, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Anderson, Craig S |e verfasserin |4 aut | |
| 700 | 1 | |a Cappelen-Smith, Cecilia |e verfasserin |4 aut | |
| 700 | 1 | |a Cordato, Dennis |e verfasserin |4 aut | |
| 700 | 1 | |a Welgampola, Miriam S |e verfasserin |4 aut | |
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