Diagnostic Value of S100B and Neuron-specific Enolase in Distinguishing Acute Central and Peripheral Vertigo

Abstract

Aim: Vertigo is a common presenting complaint to the emergency department (ED). Distinguishing between acute central and peripheral vertigo can be challenging. During recent years, several biomarkers have been introduced for use in distinguishing central and peripheral vertigo. The current study determined whether S100 calcium-binding protein B (S100B) and neuron-specific enolase (NSE) serum concentrations could effectively predict the central causes of vertigo. Materials and Methods: This was a prospective study performed on 117 patients with acute vertigo who were admitted to the ED. All patients underwent magnetic resonance imaging (MRI) and the results of the MRI were considered the gold standard. S100B and NSE from blood samples taken <8 h after the onset of symptoms were measured in all patients. Results: Finally, 117 patients were enrolled in the study, of which 43 patients had central vertigo and 74 patients had peripheral vertigo. The serum levels of S100B and NSE in the central group were significantly higher (60.62 vs 28.01 pg/mL, and 11.86 vs 7 ng/mL, p<0.001, respectively). The receiver-operating characteristic analysis demonstrated an AUC of 0.91 [95% confidence interval (CI): 0.84-0.96] and 0.93 (95% CI: 0.87-0.97) for S100B and NSE for predicting central vertigo and reported a sensitivity of 97.7% and 93% and a specificity of 87.8% and 89.2% for detecting the central cause of vertigo with S100B and NSE. Conclusion: The serum S100B and NSE concentrations in central vertigo were significantly higher, and could be useful markers in screening central from peripheral vertigo in the ED.