Abstract：
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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
目的：急性单侧外周前庭病（AUPVP）是一种常见的以单侧前庭器官功能障碍为特征的外周性前庭性眩晕。回忆和床旁检查的诊断挑战可能导致潜在的误诊。这项研究调查了床旁检查在诊断AUPVP中的敏感性。
方法：这项回顾性分析检查了2017年至2019年在三级大学医院住院的136名AUPVP患者。收集人口统计数据和床边测试结果。仪器耳神经测试包括热量测试和视频头脉冲测试（HIT）。每个床边参数的灵敏度是根据仪器诊断计算的，并进行统计分析。
结果：该研究包括76名男性和60名女性，平均年龄59.2岁.自发性眼球震颤的敏感度为92%，而不存在偏斜偏差的敏感性为98%。异常床边HIT显示87％的敏感性。组合提示(HIT,眼球震颤,和偏斜测试）的灵敏度为83％。Romberg测试和Fukuda测试显示了26％和48％的敏感性，分别。
结论：床边试验的灵敏度从26%到98%不等。这与以前的文献一致，强调仅通过床边检查区分AUPVP和前庭假性神经炎的挑战。尽管这些测试在排除主要原因方面表现出色，它们不足以确定地诊断AUPVP。此外,床边检查的敏感性差异很大，早期放射成像可能会产生误导。因此,这项研究强调了及时进行耳神经学检测的必要性,以准确排除前庭假性神经炎,从而改善患者预后.
方法：这项回顾性分析检查了2017年至2019年在三级大学医院住院的136名AUPVP患者。收集人口统计数据和床边测试结果。仪器耳神经测试包括热量测试和视频头脉冲测试（HIT）。每个床边参数的灵敏度是根据仪器诊断计算的，并进行统计分析。
结果：该研究包括76名男性和60名女性，平均年龄59.2岁.自发性眼球震颤的敏感度为92%，而不存在偏斜偏差的敏感性为98%。异常床边HIT显示87％的敏感性。组合提示(HIT,眼球震颤,和偏斜测试）的灵敏度为83％。Romberg测试和Fukuda测试显示了26％和48％的敏感性，分别。
结论：床边试验的灵敏度从26%到98%不等。这与以前的文献一致，强调仅通过床边检查区分AUPVP和前庭假性神经炎的挑战。尽管这些测试在排除主要原因方面表现出色，它们不足以确定地诊断AUPVP。此外,床边检查的敏感性差异很大，早期放射成像可能会产生误导。因此,这项研究强调了及时进行耳神经学检测的必要性,以准确排除前庭假性神经炎,从而改善患者预后.
