Clinical application value of video head impulse test in identifying acute vestibular syndrome caused by vestibular neuritis from that caused by posterior circulation stroke
Objective To investigate the clinical diagnostic value of video head impulse test(vHIT)in identifying the acute vestibular syndrome(AVS)caused by vestibular neuritis(VN)and that caused by posterior circulation stroke(PCS).Methods The clinical data of 37 patients with VN-caused AVS(group VN)and 41 patients with PCS-caused AVS(group AVS)were retrospectively analyzed.All the patients were assessed by horizontal vHIT within 7 days of onset.The diagnostic value of vHIT indexes in identifying VN and PCS was analyzed by ROC curve.Results The age,vestibulo-ocular reflex(VOR)gain of affected side,onset latency and the percentages of male patients,and the patients with hyperhomocysteinemia and history of stroke and transient ischemic attack in group VN were lower than those in group PCS,while the ratio of gain asymmetry,compensatory saccade frequency,peak velocity,amplitude and accumulated amplitude were higher in group VN than those in group PCS(P＜0.05).The AUC values of VOR gain of affected side,ratio of gain asymmetry,compensatory saccade frequency and peak velocity of affected side in the diagnosis of VN were 0.905,0.902,0.790 and 0.849,respectively(P＜0.05).Taking VOR gain of affected side 0.71 as the cut-off value,the corresponding sensitivity and specificity were 83.78％and 90.24％.When VOR gain of affected side≤0.71 combined with the ratio of gain asymmetry ≥ 10.24％,compensatory saccade frequency of affected side ≥ 137％and peak velocity of affected side ≥ 122.5 degree/second in the the diagnosis of VN,the values of sensitivity were 94.59％,91.89％and 91.89％,and the values of specificity were 80.49％,90.24％and 90.24％,respectively.Conclusion vHIT can be used in the differential diagnosis of VN and PCS.VOR gain,ratio of gain asymmetry and compensatory saccade frequency or peak velocity can improve the accuracy of identifying AVS caused by VN and PCS.
Acute vestibular syndromeVideo head impulse testPosterior circulation strokeVestibular neuritis
万方数据
维普
