Efficacy of vestibular tests for differential diagnosis of acute vestibular disorders: a cross-sectional study

Abstract Background Acute vestibular syndrome (AVS) is characterized by a severe vertigo attack that lasts longer than 24 hours, accompanied by nausea and vomiting. There are numerous clinical conditions that can cause AVS, some of which require prompt attention and a suitable differential diagnosis for the best possible outcome for the patient. While there are numerous objective vestibular tests available for the diagnosis of vestibular disorders, there are few studies that show these tests’ effectiveness for differentiating between AVS conditions. Method Aim of the present study was to investigate the predictive value of vestibular tests in differential diagnosis of acute unilateral vestibular neuropathy AUVP & VM which are common causes of AVS syndrome. This was a retrospective study of 108 patients with primary complaint of vertigo. Out of these, the clinical signs and symptoms of 17 patients were suggestive of AUVP while sign and symptoms of 10 were suggestive of VM as per the Classification of Vestibular Disorders by the Bárány Society (2022). Vestibular evoked myogenic response, both cervical and ocular (cVEMP and oVEMP) and video head impulse test (vHIT) findings were reviewed and analyzed for these selected patients. Results Chi-square analysis showed a significant association of amplitude asymmetry parameter of VEMP with type of disorder ( χ 2 = 7.1; P < 0.01). Analysis of vHIT results showed that abnormal results were observed in 14 (82%) patients with AUVN while it was abnormal in 3 (30%) patients with VM ( χ 2 = 5.1, P < 0.05). Hence, VEMP and video head impulse test both should be used to differentially diagnose the patients with AUVP from VM. Conclusions VEMP and video head impulse tests both are used to differentially diagnose the patients with AUVP from VM.