{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T02:29:58Z","timestamp":1791772198465,"version":"4.3.4"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100012317","name":"UCLH Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012317","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Differentiating between peripheral and central aetiologies can be challenging in patients with acute vertigo, given substantial symptom overlap. A detailed clinical history and focused physical eye movement examination such as the HINTS eye examination appear to be the most reliable approach to identify acute cerebellar\/brainstem stroke, outperforming even acute brain imaging. We have observed, however, that isolated vertigo of central cause may be accompanied by acute truncal ataxia, in the absence of nystagmus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We explored the frequency of ataxia without concurrent nystagmus in a cross section of patients with acute vertigo who presented to the emergency department at two centres in Argentina (Group A) and the UK (Group B). Patients underwent detailed clinical neuro\u2010otological assessments (Groups A and B), which included instrumented head impulse testing and oculography (Group B).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 71 patients in Group A and 24 patients in Group B were included in this study. We found acute truncal ataxia\u2014without nystagmus\u2014in 15% (<jats:italic>n<\/jats:italic>\u00a0=\u200914) of our overall cohort. Lesions involved stroke syndromes affecting the posterior inferior cerebellar artery, anterior inferior cerebellar artery, and superior cerebellar artery, thalamic stroke, cerebral hemisphere stroke, multiple sclerosis, and a cerebellar tumour. Additional oculomotor deficits did not reliably identify a central cause in these individuals, even with oculography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We have identified a significant subpopulation of patients with acute vertigo in whom the current standard approaches such as the HINTS examination that focus on oculomotor assessment may not be applicable, highlighting the need for a formal assessment of gait in this setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15729","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T08:57:18Z","timestamp":1675846638000},"page":"1785-1790","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Acute truncal ataxia without nystagmus in patients with acute vertigo"],"prefix":"10.1111","volume":"30","author":[{"given":"Sergio","family":"Carmona","sequence":"first","affiliation":[{"name":"Fundaci\u00f3n San Lucas para la Neurociencia  Rosario Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Hospital Jose Maria Cullen  Santa Fe Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Zalazar","sequence":"additional","affiliation":[{"name":"Hospital de San Luis Fundaci\u00f3n San Lucas para la Neurociencia  Rosario Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehzat","family":"Koohi","sequence":"additional","affiliation":[{"name":"Institute of Neurology University College London  London UK"},{"name":"Ear Institute University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0591-646X","authenticated-orcid":false,"given":"Diego","family":"Kaski","sequence":"additional","affiliation":[{"name":"Institute of Neurology University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2015.04.002"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.551234"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13960"},{"issue":"7","key":"e_1_2_8_5_1","first-page":"125","article-title":"The diagnostic accuracy of truncal ataxia and HINTS as cardinal signs for acute vestibular syndrome","volume":"8","author":"Carmona S","year":"2016","journal-title":"Front Neurol"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.24.1.76"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016488809102861"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.24.11.1697"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000238500.02302.b4"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.53.9.731"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.57.9.1073"},{"key":"e_1_2_8_12_1","volume-title":"Posterior Circulation Disease. 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