BACKGROUND AND PURPOSE Acute vestibular syndrome (AVS) is often due to vestibular neuritis but can result from vertebrobasilar strokes. Misdiagnosis of posterior fossa infarcts in emergency care settings is frequent. Bedside oculomotor findings may reliably identify stroke in AVS, but prospective studies have been lacking. METHODS The authors conducted a prospective, cross-sectional study at ...

Dizziness and vertigo without neurological signs are typically due to a peripheral vestibular disease. Although the most common causes are benign, differential diagnosis must include potentially life-threatening central diseases such as cerebrovascular pathologies. A systemic clinical approach needs a careful work-up, bedside examination and appropriate instrumental investigation. The head impu...

A 31-year-old patient had acute dizziness and lateropulsion to the right. Neuro-ophthalmologic examination revealed (1) a saccade gaze palsy left (video 1, part A), (2) “half-pathologic” head-impulse test right B), but (3) bilaterally normal adduction during convergence reaction C), findings typical for abducens nuclear palsy. It was caused by histologically proven cavernoma in tegmentum pontis...

OBJECTIVE To characterize the response in the video head-impulse test for the assessment of the vestibulo-ocular reflex (VOR) in patients because of vertigo and dizziness. MATERIALS AND METHODS After rightward and leftward head impulses, the following results evaluated were: gain of the reflex and appearance of refixation saccades. A particular type of response (normal gain VOR and refixation...

Differentiating central from peripheral origins of vestibulo-ocular reflex (VOR) lesions can be challenging. A 36-year old man presented with a 1-year history of progressive unsteadiness. The video-Head Impulse Test revealed a significantly reduced VOR gain in both horizontal and posterior canals (0.49 ± 0.05 and 0.38 ± 0.06) but normal VOR responses in both anterior canals (0.89 ± 0.08 and 1.0...

Identifying unilateral vestibular failure of the semicircular canals (SCC) is important in vertigo and dizziness disease. There are different vestibular tests available: rotatory testing (RT), bithermal caloric irrigation (CI) and the video-head-impulse test (vHIT). This review comments on the current knowledge and on economic aspects of the testing methods. RT are a very specials tests and sho...

Background Wernicke's encephalopathy (WE), a metabolic disorder due to thiamine deficiency, manifests with various neurological symptoms and signs. It has been known as a cause of vestibular dysfunction. Preliminary reports have proposed predominant involvement of the horizontal semicircular canals (HSCs). Objective To better characterize the pattern of vestibular impairment in patients with ...

Objectives: The objective of this study was to analyze vestibulocochlear function results in patients identified with isolated semicircular canal (SCC) hypofunction using the video head impulse test (vHIT).Methods: A retrospective review conducted on clinical records 123 diagnosed SCC based vHIT results. Among these patients, 72 had posterior (PSCC) hypofunction, 25 lateral (LSCC) and 26 anteri...

Thiamine deficiency may cause Wernicke encephalopathy (WE) characterized by ataxia, ophthalmoplegia, and confusion. Aside from the triad of cardinal symptoms, selective or predominant impairments bilateral horizontal canals be observed in WE. Here, we report a patient with gastric mucosa-associated lymphoid tissue (MALT)-lymphoma complicated an early stage WE due to thiamine manifesting vestibu...