Acute unilateral peripheral and central vestibular lesionscan cause similar signs and symptoms, but they requiredifferent diagnostics and management. We thereforecorrelated clinical signs to differentiate vestibular neuritis(40 patients) from central ‘‘vestibular pseudoneuritis’’ (43patients) in the acute situation with the final diagnosisassessed by neuroimaging. Skew deviation was the onlyspecific but non-sensitive (40%) sign for pseudoneuritis.None of the other isolated signs (head thrust test,saccadic pursuit, gaze evoked nystagmus, subjectivevisual vertical) were reliable; however, multivariatelogistic regression increased their sensitivity and specificityto 92%.
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