Do central vestibular findings predict abnormal findings on magnetic resonance imaging?

Objective

To determine whether central findings from vestibular tests predict abnormal findings on magnetic resonance imaging.

Method

This study was a retrospective case series at a tertiary referral centre. The main outcome measure of this diagnostic intervention study was the positive predictive value of central vestibular findings in relation to magnetic resonance imaging abnormalities.

Results

Central vestibular findings had a 50.9 per cent positive predictive value for magnetic resonance imaging abnormalities across all age groups although they varied according to age group. Optokinetic nystagmus (p < 0.05) and abnormal findings on videonystagmography tests (p < 0.05) were the main predictors of magnetic resonance imaging abnormalities. White matter lesions constituted the bulk of the central lesions on magnetic resonance imaging followed by cortical and cerebellar atrophy.

Conclusion

Central vestibular findings had a 50.9 per cent positive predictive value for magnetic resonance imaging abnormalities across all age groups. Magnetic resonance imaging is medically justified to further evaluate patients with central findings on vestibular studies. Therefore, it is reasonable to request magnetic resonance imaging in these patients.

[Vestibular migraine: diagnostic difficulties and treatment optimization]

AIM

The study aimed at showing actual information about vestibular migraine and presenting different features of vestibular migraine for prevention of diagnostic mistakes and choosing an effective treatment.

MATERIAL AND METHODS

Fifty patients with vestibular migraine were diagnosed according to the International Classification of Headache Disorders 3rd edition and examined in a neurological department.

RESULTS

Problems with outpatient diagnosis and treatment were found. Many patients were not diagnosed correctly and, therefore, did not receive effective management of vestibular migraine. All clinical features, information of disease history and different objective signs were important for differential diagnosis with other types of dizziness. Management according to guidelines for migraine treatment and recent research of vestibular migraine showed its efficiency for patients.

CONCLUSION

Spreading of actual information about vestibular migraine is important due to its underdiagnosis. Knowledge of clinical features is helpful for diagnosis and differential diagnosis. Treatment approaches according to guidelines and last research should be used.