Bedside differentiation of vestibular neuritis from central "vestibular pseudoneuritis".

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%.