Isolated Vestibular Nucleus Infarction Mimicking Acute Peripheral Vestibulopathy

• Published in: Stroke (1970) Vol. 41; no. 7; pp. 1558 - 1560
• Main Authors: KIM, Hyun-Ah, LEE, Hyung
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01-07-2010
• Subjects: Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Brain Stem Infarctions - diagnosis; Brain Stem Infarctions - drug therapy; Diagnosis, Differential; Female; Humans; Medical sciences; Middle Aged; Neurology; Pharmacology. Drug treatments; Platelet Aggregation Inhibitors - therapeutic use; Vascular diseases and vascular malformations of the nervous system; Vestibular Neuronitis - diagnosis; Vestibular Neuronitis - drug therapy; Vestibular Nuclei - pathology; Stroke; Nervous system diseases; Infarct; infarction; Cardiovascular disease; vestibular nucleus; Differential diagnostic; Vertigo; Cerebral disorder; isolated vertigo; Vascular disease; Equilibrium disorder; pseudo-acute peripheral vestibulopathy; Central nervous system disease; ENT disease; Cerebrovascular disease
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/strokeaha.110.582783

Although several articles have been published on central vestibular syndrome mimicking acute peripheral vestibulopathy (ie, pseudo-acute peripheral vestibulopathy), there are no reports of a brainstem infarct that selectively involves the vestibular nucleus and causes isolated vertigo.
We report a patient with an isolated vestibular nucleus infarction who presented with isolated prolonged vertigo, spontaneous horizontal nystagmus with a torsional component, a positive head impulse test result, and unilateral canal paresis to caloric stimulation.
This is the first report of pseudo-acute peripheral vestibulopathy associated with isolated vestibular nucleus infarction. Isolated vestibular nucleus infarction should be considered in the differential diagnosis of central vascular vertigo syndrome, especially when the patient has unilateral canal paresis but without other neurologic symptoms or signs.