ArticleJournal of neurology2023
Modern vestibular tests can accurately separate stroke and vestibular neuritis.
Article in Journal of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- The Epidemiology and Clinical Presentation of the Acute Imbalance Syndrome (AIS)-A Systematic Review and Meta-Analysis.European journal of neurology · 2026Pooled it
- The epidemiology and clinical presentation of acute vestibular syndromes: a systematic review of the literature.Journal of neurology · 2026Pooled it
- Accuracy of video head impulse test in stroke diagnosis during acute vestibular syndrome: a systematic review with meta-analysis.Journal of neurology · 2025Pooled it
- Separating stroke and acute unilateral vestibulopathy using history, examination and vestibular tests: a machine learning approach.Journal of neurology · 2026Article
- A digital neurotology history: Characteristics and inter-rater reliability.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- Acute vertigo and dizziness: the diagnostic potential of static posturography in the neurological emergency department.Journal of neurology · 2026Article
- Prediction Model for Etiologic Differentiation of Isolated Vestibular Syndrome in Emergency Settings.Annals of clinical and translational neurology · 2026Article
- Article
- Mechanisms of VOR Suppression in Brainstem Pathology: Insights from the Absence of Anti-Compensatory Saccades Despite Normal VOR Gain.Audiology research · 2025Article
- Accuracy of First-Line Tests for Posterior Circulation Stroke in the Emergency Department: A Scoping Review.Cureus · 2025Review
- Clinical Features, Video Head Impulse Test, and Subjective Visual Vertical of Acute and Symptom-Free Phases in Patients with Definite Vestibular Migraine.Biomedicines · 2025Article
- Separation of stroke from vestibular neuritis using the video head impulse test: machine learning models versus expert clinicians.Journal of neurology · 2025Article
- Acute vestibular syndrome induced by supratentorial stroke: clinical features and network compensation mechanisms.Frontiers in neurology · 2025Article
- Video head impulse test in subacute and chronic stroke survivors: new perspectives for implementation of assessment in rehabilitation.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2024Article
- Trunk Instability in the Pitch, Yaw, and Roll Planes during Clinical Balance Tests: Axis Differences and Correlations to vHIT Asymmetries Following Acute Unilateral Vestibular Loss.Brain sciences · 2024Article
- Application of a Video Head Impulse Test in the Diagnosis of Vestibular Neuritis.Life (Basel, Switzerland) · 2024Review
- Neurological update: neuro-otology 2023.Journal of neurology · 2023Article
- The clinical value of vHIT saccadic parameters in the diagnosis and management of central vestibular disorders: a narrative review.Frontiers in neurologyReview
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo separate posterior-circulation stroke (PCS) and vestibular-neuritis (VN) using quantitative vestibular tests.
methodsPatients were prospectively recruited from the emergency room within 72 h of presentation. Video-nystagmography (VNG), three-dimensional video head-impulse testing (vHIT), vestibular-evoked myogenic potentials (VEMPs), and subjective visual-horizontal (SVH) were performed.
resultsThere were 128 PCS and 134 VN patients. Common stroke-territories were: posterior-inferior cerebellar artery, basilar-perforators, multi-territory and anterior-inferior cerebellar artery (41.4%, 21.1%, 14.1%, 7.8%). VN included superior, inferior and pan-neuritis (53.3%, 4.2%, and 41.5%). Most VN and stroke patients presented with acute vestibular syndrome (96.6%, 61.7%). In VN, we recorded horizontal (98.5%) or vertical/torsional spontaneous nystagmus (1.5%) and in PCS, absent-nystagmus (53.9%), horizontal (32%) or vertical/torsional (14.1%) nystagmus. The mean slow-phase velocity of horizontal nystagmus was faster in VN than PCS (11.8 ± 7.2 and 5.2 ± 3.0°/s, p < 0.01). Ipsilesional horizontal-canal (HC) vHIT-gain was lower in VN than in stroke (0.47 ± 0.24, 0.92 ± 0.20, p < 0.001). Ipsilesional catch-up saccades occurred earlier, and their amplitude, prevalence, and velocity were greater in VN than PCS (p < 0.01). Ipsilesional SVH deviation > 2.5° occurred more often in VN than in stroke (97.6% and 24.3%, p < 0.01). Abnormal bone-conducted ocular-VEMP asymmetry ratio was more common in VN than PCS (50% and 14.4%, p < 0.01). Using the ten best discriminators (VNG, vHIT, SVH, and oVEMP metrics), VN was separated from PCS with a sensitivity of 92.9% and specificity of 89.8%. Adding VNG and vHIT to the bedside head-impulse-nystagmus-and-test-of-skew (HINTS) test enhanced sensitivity and specificity from 95.3% and 63.4% to 96.5% and 80.6%.
conclusionQuantitative vestibular testing helps separate stroke from vestibular neuritis and, when used, could improve diagnostic accuracy in the emergency room.
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