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

J Neurol Sci. 2022 Oct 15:441:120374. doi: 10.1016/j.jns.2022.120374. Epub 2022 Aug 9.

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: Acute vestibular syndrome; Flexor asynergy; Inability to sit still; Truncal ataxia.

MeSH terms

  • Ataxia / diagnosis
  • Humans
  • Stroke* / diagnosis
  • Stroke* / diagnostic imaging
  • Vertigo / diagnosis
  • Vestibular Neuronitis* / complications
  • Vestibular Neuronitis* / diagnosis