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KMID : 0390220040150020311
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Journal of Clinical Otolaryngology, Head and Neck Surgery
2004 Volume.15 No. 2 p.311 ~ p.315
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A Case of Cerebellar Infartion Misdiagnosed as Lateral Semicircular Canal Cupulolithiasis
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Hwang Chan-Ho
Kim Bo-Young
Bae Woo-Yong
Park Kyung-Won
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Abstract
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Benign Paroxysmal Positional Vertigo (BPPV) is the most common peripheral vestibular disorder. It can be diagnosed
with characteristic symptoms and the nystagmus evoked by the positional change. We report a case of cerebellar infarction misdiagnosed as BPPV. A 58 years-old man, complaining rotatory positional vertigo for 3 days, visited our OPD. A head positional test was performed. and it induced positional ageotrophic nystagmus. He showed no neurologic abnormality in neurologic examination. We diagnosed his illness as cupulolithiasis of horizontal canal, so the cupulolith repositioning maneuver, applying vibrator on mastoid tip and forced prolonged position maneuver were performed. Then, the vertigo and the intensity of nystagmus were improved. Four days later, however, vertigo was aggrevated again showing same nystagmus. So we recommended magnetic resonance imaging, and multiple cerebellar infarctions were found. Even if patient shows typical nystagmus of BPPV, the neuroradiologic study should be conducted to rule out central lesion, in the case of no response to repositioning maneuver or reaggrevation.
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KEYWORD
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Brain infarction, Paroxysmal vertigo
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