Korean J Otorhinolaryngol-Head Neck Surg.  2014 Aug;57(8):552-555. 10.3342/kjorl-hns.2014.57.8.552.

A Case of Pseudo-Vestibular Neuritis with Contralesional Canal Paresis due to Spontaneous Bilateral Vertebral Artery Dissection

• Shim DB
• Song MH
• Park KC
• Song CE

• KMID: 1716017
• DOI: http://doi.org/10.3342/kjorl-hns.2014.57.8.552

Abstract

Pseudo-vestibular neuritis is a central pathology of acute vestibular syndrome, characterized by unidirectional nystagmus mimicking acute peripheral vestibulophaty. We report a 39-year-old female patient who developed cerebellar infarction with isolated vertigo, spontaneous nystagmus, a positive head thrust test, and unilateral canal paresis in the contralesional side. The patient had no vascular risk factors. A diffusion-weighted image of the brain showed infarction of medial branch of posterior inferior and superior cerebellar artery on the left side. A magnetic resonance angiography of neck disclosed a wide range of diffused severe stenosis and narrowing of right and left vertebral arteries, respectively. This case suggests the possibility of vestibular ischemia masking the central pathology in isolated vertigo.

Keyword

Embolism; Vertebral artery dissection; Vestibular neuritis

MeSH Terms

Adult
Arteries
Brain
Constriction, Pathologic
Embolism
Female
Head Impulse Test
Humans
Infarction
Ischemia
Magnetic Resonance Angiography
Masks
Neck
Neuritis*
Nystagmus, Pathologic
Paresis*
Pathology
Risk Factors
Vertebral Artery
Vertebral Artery Dissection*
Vertigo
Vestibular Neuronitis