Acute unilateral peripheral and central vestibular lesions
can cause similar signs and symptoms, but they require
different diagnostics and management. We therefore
correlated clinical signs to differentiate vestibular neuritis
(40 patients) from central ‘‘vestibular pseudoneuritis’’ (43
patients) in the acute situation with the final diagnosis
assessed by neuroimaging. Skew deviation was the only
specific but non-sensitive (40%) sign for pseudoneuritis.
None of the other isolated signs (head thrust test,
saccadic pursuit, gaze evoked nystagmus, subjective
visual vertical) were reliable; however, multivariate
logistic regression increased their sensitivity and specificity
to 92%
