Seol Hee Baek1, Jeong Yoon Choi2, Jin Man Jung3, Do Young Kwon3, Moon Ho Park3, June Choi4, Ji Soo Kim5. 1. Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea. 2. Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea. a-yeong@hanmail.net. 3. Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea. 4. Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea. 5. Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Abstract
BACKGROUND: The findings of head impulse tests (HIT) are usually normal in cerebellar lesions. CASE REPORT: A 46-year-old male presented with progressive dizziness and imbalance of 3 weeks duration. The patient exhibited catch-up saccades during bedside horizontal HIT to either side, which was more evident during the rightward HIT. However, results of bithermal caloric tests and rotatory chair test were normal. MRI revealed a lesion in the inferior cerebellum near the flocculus. CONCLUSIONS: This case provides additional evidence that damage to the flocculus or its connections may impair the vestibulo-ocular reflex only during high-speed stimuli, especially when the stimuli are applied to the contralesional side. By observing accompanying cerebellar signs, the abnormal HIT findings caused by a cerebellar disorder can be distinguished from those produced by peripheral vestibular disorders.
BACKGROUND: The findings of head impulse tests (HIT) are usually normal in cerebellar lesions. CASE REPORT: A 46-year-old male presented with progressive dizziness and imbalance of 3 weeks duration. The patient exhibited catch-up saccades during bedside horizontal HIT to either side, which was more evident during the rightward HIT. However, results of bithermal caloric tests and rotatory chair test were normal. MRI revealed a lesion in the inferior cerebellum near the flocculus. CONCLUSIONS: This case provides additional evidence that damage to the flocculus or its connections may impair the vestibulo-ocular reflex only during high-speed stimuli, especially when the stimuli are applied to the contralesional side. By observing accompanying cerebellar signs, the abnormal HIT findings caused by a cerebellar disorder can be distinguished from those produced by peripheral vestibular disorders.
Entities:
Keywords:
flocculus; head impulse test; vertigo; vestibulo-ocular reflex
Authors: Hyo Jung Kim; Seong Ho Park; Ji Soo Kim; Ja Won Koo; Chae Yong Kim; Young Hoon Kim; Jung Ho Han Journal: J Clin Neurol Date: 2016-01 Impact factor: 3.077
Authors: Ju Young Lee; Eunjin Kwon; Hyo Jung Kim; Jeong Yoon Choi; Hui Jong Oh; Ja Won Koo; Ji Soo Kim Journal: J Clin Neurol Date: 2020-04 Impact factor: 3.077