Res Vestib Sci.  2021 Jun;20(2):69-73. 10.21790/rvs.2021.20.2.69.

Acute Vestibular Syndrome Preceded by Otologic Symptoms in Sarcoidosis

• Park HJ
• Kim JM
• Choi HS
• Lee T
• Lee SH

• KMID: 2516823
• DOI: http://doi.org/10.21790/rvs.2021.20.2.69

Abstract

Sarcoidosis is a rare, multisystem granulomatous disease. Neurological complications occur in about 5% of patients and vestibulocochlear involvement is even rarer. A 27-year-old woman presented with acute spontaneous vertigo for 5 days. She was diagnosed with pulmonary sarcoidosis 4 months ago, but specific treatments have not yet started. She had preceding otologic symptoms including bilateral tinnitus and ear fullness in the right for 3 months without hearing loss. Initial bedside examinations revealed spontaneous right-beating nystagmus and abnormal catch-up saccades in the left during head impulse tests (HIT). After 2 weeks, video-oculography documented the direction of spontaneous nystagmus was changed into left-beating. Caloric test showed canal paresis in the left, and video HIT showed subtle covert saccades. After starting oral prednisolone, her symptoms improved rapidly. In our case, acute vestibular syndrome and otologic symptoms might be associated with sarcoidosis when considering clinical course and treatment response. Sarcoidosis may be considered as a cause in cases with audiovestibulopathy of unknown etiology.

Keyword

Sarcoidosis; Vestibulocochlear nerve; Acute vestibular syndrome; 사르코이드증; 청각전정병증; 자기공명영상; 급성전정증후군