S-Space College of Medicine/School of Medicine (의과대학/대학원) Dept. of Neurology (신경과학교실) Journal Papers (저널논문_신경과학교실)
Isolated central vestibular syndrome
- Kim, Sung-Hee; Park, Seong-Ho; Kim, Hyo-Jung; Kim, Ji-Soo
- Issue Date
- Annals of the New York Academy of Sciences, vol.1343, pp. 80-89
- vertigo; vestibular nucleus; nucleus prepositus hypoglossi; flocculus; tonsil; nodulus; inferior cerebellar
- Isolated vestibular syndrome may occur all along the vestibular pathways from the peripheral labyrinth to the brain.
By virtue of recent developments in clinical neurotology and neuroimaging, however, diagnosis of isolated central
vestibulopathy is increasing. Here, we review five distinct syndromes of isolated central vestibular syndrome from
lesions restricted to the vestibular nuclei, the nucleus prepositus hypoglossi, the flocculus, the tonsil, and the nodulus,
and introduce a new vestibular syndrome from isolated involvement of the inferior cerebellar peduncle. Decreased
responses to head impulses do not exclude a central lesion as a cause of isolated vestibular syndrome. Brain imaging,
including diffusion-weighted magnetic resonance imaging (MRI), may be falsely negative during the acute phase in
patients with isolated vestibular syndrome because of a stroke. Central signs should be sought carefully in patients
with isolated vertigo, even when the patients show the features of peripheral vestibulopathy and negative MRIs.
Recognition of these isolated central vestibular syndromes would aid in defining the lesions responsible for various
vestibular manifestations in central vestibulopathy.
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