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  Patronage of the Polish Society of Audiology and Phoniatrics

vol 13. no 1. March 2014  

 Review articles
Acute Vestibular Syndrome – is it a stroke? Bedside examination as a keystone of differential diagnosis
Beata Błażejewska-Hyżorek

Acute vestibular syndrome (AVS) is characterized by rapid onset
of vertigo, nausea/vomiting, and gait unsteadiness in association
with head motion intolerance and nystagmus. Most of the affected
patients show signs of acute peripheral vestibulopathy.
The peripheral causes of AVS include acute vestibular neuritis,
Meniere’s disease, and migraine. Recent studies have shown that
cerebellar and brainstem infarctions that resemble preipheral
AVS are more common than previously thought, while they
are not accompanied by symptoms of central nervous system
involvement. From the clinical perspective it is important to
distinguish between vascular-related central AVS and peripheral
AVS because therapeutic strategy and prognosis for those two
conditions are different. Three-step bedside oculomotor examination
with head impulse test and assessment of nystagmus
and skew deviation is more sensitive for stroke than early MRI
and is the most useful tool for differentiating the central from
the peripheral AVS.

keywords: ostry zespół przedsionkowy, udar móżdżku i pnia mózgu, HINTS, oczopląs, test pchnięcia głową, skośneodchylenie gałek ocznych, acute vestibular syndrome, cerebellar and brainstem stroke, HINTS, head impulse test, nystagmus, skew deviation

pages: from 12 to 16

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