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DOI: 10.1055/s-0038-1639950
Progressive vertigo without neurological deficit
In emergency treatment, clear differentiation between Peripheral Vestibular Disorder and cerebrovascular insult is particularly important. In cases where results of otoneurological assessment are seemingly unambiguous, clinical worsening may lead to a cerebral cause for vertigo.
Case study:
A 57-year old patient was admitted to the emergency department, presenting with acute rotary vertigo, nausea and vomiting. Otoneurological assessment revealed a spontaneous nystagmus to the left, Romberg test showed tendency to fall to the right, Unterberger's stepping test revealed rotation to the right and the head-impulse test to the right showed a corrective saccade. In the other neurological examinations there were inconspicuous findings. Presenting a clinical worsening on the following day the patient showed a discreet dysdiadochkinesis and the cCT unmasked a cerebellar infarction extending to a brainstem infarction later on. The patient died after five days.
Publication History
Publication Date:
23 May 2018 (online)
© 2018. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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