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Role of incubitus truncal ataxia, and equivalent standing grade 3 ataxia in the diagnosis of central acute vestibular syndrome

Published:August 09, 2022DOI:https://doi.org/10.1016/j.jns.2022.120374

      Highlights

      • AVS requires a rapid and accurate evaluation to determine its etiology.
      • Truncal ataxia is shown as a sign that is easy to evaluate and very useful in the etiological diagnosis of AVS.
      • For those cases in which the patient cannot stand, assessing the incubitus truncal ataxiais a good substitute for truncal ataxia.

      Abstract

      Introduction and objectives

      acute vestibular syndrome is a diagnostic challenge, requiring a rapid and precise diagnosis to take therapeutic actions. Truncal ataxia, inability to sit still, and Babinski flexor dysergy were evaluated. Material anf methods: 52 patients with central pathology (stroke in aica and pica territory) and vestibular neuritis were prospectively studied. MRI of the brain was used as the gold standard.

      Results

      A combination of grade 2–3 ataxia to differentiate patients with vestibular neuritis from patients with stroke resulted in a 92% sensitivity (95% CI 79–100%), a 67% specificity (95% CI 47–86%). Flexion asynergy had a 70% sensitivity (95% CI 47–92%), and an 88% specificity (95% CI 69–100%). The inability to sit still correlated well with truncal ataxia.

      Conclusions

      vestibulospinal signs are useful in the differential diagnosis of acute vestibular syndromes, and the inability to sit is a good substitute for truncal ataxia when it cannot be evaluated.

      Keywords

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