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KMID : 1036520180080020037
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Clinical Neuro-Ophthalmology
2018 Volume.8 No. 2 p.37 ~ p.40
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Clinical Diagnosis of Labyrinth Infarction: Report of a Case and Literature Review
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Jeon Seung-Ho
Shin Byoung-Soo
Seo Man-Wook
Oh Sun-Young
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Abstract
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Labyrinth infarction is leading to prolonged vertigo and hearing loss without other brainstem or cerebellar symptoms or signs, which are indistinguishable from viral labyrinthitis. If brainstem or cerebellar lesions manifest vertigo without other neurological signs, they are easily misdiagnosed as peripheral-type of vertigo. Herein, we report a patient with stenosis of mid basilar artery presenting with prolonged vertigo, unidirectional spontaneous nystagmus and ipsilateral sensory hearing impairment. The symptoms and signs resembled acute peripheral labyrinthitis, and the caveats for differential diagnosis were discussed. A 75-year-old female visited the emergency room due to acute onset of severe vertigo, nausea and gait ataxia. Neurologic examination revealed the left-beating horizontal-torsional mixed nystagmus, dysmetria on the left side and falling tendency to the left during tandem gait. Hearing impairment on the right ear was also observed. Video head-impulse test (vHIT) revealed a covert and overt catch-up saccade in right posterior and lateral canals. Brain magnetic resonance imaging showed acute multifocal infarctions in the cerebellum, occipital and frontal lobe on the left side and the right occipital lobe. Brain magnetic resonance angiography showed mid basilar artery stenosis. We diagnosed as acute infarction due to a stenosis of basilar artery which supply labyrinthine arteries. Physician should consider labyrinthine artery infarction in patients with acute onset of severe vertigo with unilateral hearing impairment.
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KEYWORD
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Inner ear infarction, Anterior inferior cerebellar artery, Labyrinth infarction
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