Proceedings 31st Symposium ESVN-ECVN

The prevalence of intracranial disease in the examined population was 65.7% (266/405 cases). The overall sensitivity of the menace response was 34.6% (28.9‐40.6% p = 0.05). The overall specificity of the test was 76.3% (68.3‐83.1% p = 0.05). Subset analysis of test results in patients with intracranial lesions at MRI outlined how test characteristics change with neurolocalisation. Likelihood ratio analysis indicates that the menace response possesses little to no diagnostic value for lesions in the myelencephalon. It is of highest utility for multifocal lesions, and lesions in the forebrain, whereby a positive result is a useful indicator of a possible intracranial lesion. The post‐test probability of forebrain and multifocal lesion diagnosis is increased by 15‐20%.We propose that an absent menace response is a practical indicator of intracranial disease, but that a normal menace response does not equivocally exclude intracranial pathology. We also propose that the diagnostic utility of the test result varies with intracranial neurolocalisation.