Wydawnictwo Medyczne Mediton
quarterly

Under the scientific patronage of

the Polish Society of Audiology and Phoniatrics

 

Review articles

« return
Acute Vestibular Syndrome – is it a stroke? Bedside examination as a keystone of differential diagnosis
Beata Błażejewska-Hyżorek 1/
  • 1/ II Klinika Neurologii, Instytut Psychiatrii i Neurologii w Warszawie

Acute vestibular syndrome (AVS) is characterized by rapid onset of vertigo, nausea/vomiting, and gait unsteadiness in association with head motion intolerance and nystagmus. Most of the affected patients show signs of acute peripheral vestibulopathy. The peripheral causes of AVS include acute vestibular neuritis, Meniere’s disease, and migraine. Recent studies have shown that cerebellar and brainstem infarctions that resemble preipheral AVS are more common than previously thought, while they are not accompanied by symptoms of central nervous system
involvement. From the clinical perspective it is important to distinguish between vascular-related central AVS and peripheral AVS because therapeutic strategy and prognosis for those two conditions are different. Three-step bedside oculomotor examination with head impulse test and assessment of nystagmus and skew deviation is more sensitive for stroke than early MRI and is the most useful tool for differentiating the central from the peripheral AVS.

Otorynolaryngologia vol 13. no 1. Marchpages: from 12to 16
full version