EBQ:Jolt Test: Difference between revisions

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==Definition==
*Horizontal rotation of the head at frequency of 2 rotations/second - exacerbation of pre-existing headache is positive test.
*Although a 1991 study<ref>Jolt accentuation of headache: the most sensitive sign of CSF pleocytosis. Headache. 1991 Mar;31(3):167-71.</ref> showed high sensitivity with this test, multiple newer studies have cast doubt on its sensitivity<ref>Absence of jolt accentuation of headache cannot accurately rule out meningitis in adults. Am J Emerg Med. 2013 Nov;31(11):1601-4</ref><ref>Jolt accentuation of headache and other clinical signs: poor predictors of meningitis in adults. Am J Emerg Med. 2014 Jan;32(1):24-8</ref>. Although it may be clinically useful in the right subset of patients, it should not be considered to be 100% Sn
==Clinical Question==
==Clinical Question==



Revision as of 02:50, 17 September 2015

Definition

  • Horizontal rotation of the head at frequency of 2 rotations/second - exacerbation of pre-existing headache is positive test.
  • Although a 1991 study[1] showed high sensitivity with this test, multiple newer studies have cast doubt on its sensitivity[2][3]. Although it may be clinically useful in the right subset of patients, it should not be considered to be 100% Sn

Clinical Question

Pro Argument

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Con Argument

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Sources

  1. Jolt accentuation of headache: the most sensitive sign of CSF pleocytosis. Headache. 1991 Mar;31(3):167-71.
  2. Absence of jolt accentuation of headache cannot accurately rule out meningitis in adults. Am J Emerg Med. 2013 Nov;31(11):1601-4
  3. Jolt accentuation of headache and other clinical signs: poor predictors of meningitis in adults. Am J Emerg Med. 2014 Jan;32(1):24-8