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KMID : 1130620150110030279
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Journal of Clinical Neurology
2015 Volume.11 No. 3 p.279 ~ p.282
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Abnormal Head Impulse Test in a Unilateral Cerebellar Lesion
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Baek Seol-Hee
Choi Jeong-Yoon
Jung Jin-Man
Kwon Do-Young
Park Moon-Ho
Choi June
Kim Ji-Soo
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Abstract
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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.
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KEYWORD
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vertigo, flocculus, head impulse test, vestibulo-ocular reflex
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