对疑似急性单侧外周性前庭神经病患者进行床旁检查的准确性。

IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY
Maximilian von Bernstorff, Theresa Obermueller, Julia Blum, Erdi Hoxhallari, Veit M Hofmann, Annett Pudszuhn
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引用次数: 0

摘要

目的:急性单侧外周性前庭大血管病变(AUPVP)是一种常见的外周性前庭性眩晕,以单侧前庭器官功能障碍为特征。诊断方面的挑战在于病史和床边检查,这可能会导致误诊。本研究调查了床旁检查对诊断 AUPVP 的敏感性:这项回顾性分析研究了2017年至2019年期间一家三级甲等大学医院的136名AUPVP住院患者。收集了人口统计学数据和床旁检查结果。耳神经学仪器测试包括热量测试和视频头脉冲测试(HIT)。根据仪器诊断结果计算各床旁参数的敏感性,并进行统计分析:研究对象包括 76 名男性和 60 名女性,平均年龄为 59.2 岁。自发性眼球震颤的灵敏度为 92%,而无偏斜的灵敏度为 98%。异常床旁 HIT 的灵敏度为 87%。综合 HINTS(HIT、眼球震颤和偏斜测试)的灵敏度为 83%。朗伯格试验和福田试验的灵敏度分别为 26% 和 48%:结论:床旁测试的灵敏度从 26% 到 98% 不等。结论:床旁检查的敏感性从 26% 到 98% 不等,这与之前的文献一致,强调了仅通过床旁检查区分 AUPVP 和前庭性假性神经炎的挑战性。虽然这些检查在排除中枢性病因方面表现出色,但不足以明确诊断 AUPVP。此外,床旁检查的灵敏度差异很大,而早期放射成像可能会产生误导。因此,本研究强调了及时进行耳神经系统检查以准确排除前庭性假性耳炎的必要性,从而改善患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Accuracy of the Bedside Examination in Patients With Suspected Acute Unilateral Peripheral Vestibulopathy.

Objective: Acute unilateral peripheral vestibulopathy (AUPVP) is a frequent form of peripheral vestibular vertigo characterized by unilateral vestibular organ dysfunction. Diagnostic challenges in anamnesis and bedside examination can lead to potential misdiagnoses. This study investigated the sensitivity of bedside examinations in diagnosing AUPVP.

Methods: This retrospective analysis examined 136 AUPVP inpatients at a level 3 university hospital between 2017 and 2019. Demographic data and bedside test results were collected. Instrumental otoneurological tests included caloric testing and video head impulse test (HIT). The sensitivity of each bedside parameter was computed based on the instrumental diagnostics, and statistical analyses were performed.

Results: The study included 76 men and 60 women, with a mean age of 59.2 years. Spontaneous nystagmus exhibited a sensitivity of 92%, whereas the absence of skew deviation was identified with a sensitivity of 98%. Abnormal bedside HIT showed a sensitivity of 87%. The combined HINTS (HIT, nystagmus, and test of skew) had a sensitivity of 83%. The Romberg test and Fukuda test demonstrated sensitivities of 26% and 48%, respectively.

Conclusion: The sensitivity of bedside tests varied from 26% to 98%. This aligns with previous literature, highlighting the challenge of differentiating AUPVP from vestibular pseudoneuritis solely through bedside examination. Although the tests excel in excluding central causes, they are insufficient for diagnosing AUPVP with certainty. In addition, the bedside examination sensitivities vary widely, and early radiological imaging can be misleading. Therefore, this study underlines the necessity of prompt otoneurological testing for accurate exclusion of vestibular pseudoneuritis and thus improve patient outcomes.

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来源期刊
Neurologist
Neurologist 医学-临床神经学
CiteScore
1.90
自引率
0.00%
发文量
151
审稿时长
2 months
期刊介绍: The Neurologist publishes articles on topics of current interest to physicians treating patients with neurological diseases. The core of the journal is review articles focusing on clinically relevant issues. The journal also publishes case reports or case series which review the literature and put observations in perspective, as well as letters to the editor. Special features include the popular "10 Most Commonly Asked Questions" and the "Patient and Family Fact Sheet," a handy tear-out page that can be copied to hand out to patients and their caregivers.
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