EVALUATION OF EFFICACY OF HINTS EXAMINATION IN DIFFERENTIATING BETWEEN POSTERIOR CIRCULATION STROKE FROM PERIPHERAL VESTIBULAR LESIONS IN PATIENTS PRESENTING WITH ACUTE VESTIBULAR SYNDROME: A PROSPECTIVE, CROSS-SECTIONAL STUDY

Background and Aim:Acute vestibular syndrome(AVS) is a subset of dizziness typically accompanied by nausea, vomiting, nystagmus, gait imbalance, and continuous vertigo that may be due to a benign,peripheral cause versus a central cause. Differentiating between the two is challenging. We aimed to assess the efficacy and diagnostic accuracy of the HINTS examination in distinguishing posterior circulation stroke (PCS) from peripheral vestibular disorders (PVD) in patients presenting with AVS.

Methodology:This is a prospective, cross-sectional study consisting of total 100 patients presented with AVS. The HINTS examination was performed with three of its components viz.the Head Impulse Test(HIT),Nystagmus assessment,and the Test of Skew(TS)by properly trained clinicians. All patients completed neuroimaging as reference standard. Final diagnosis and the results of HINTS examination were compared and analysed to determine the sensitivity (Sn), specificity(Sp),positive predictive value(PPV),negative predictive value (NPV) of HINTS examination along with its diagnostic accuracy.