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Bechterew's Phenomenon in Bilateral Sequential Vestibular Neuritis: A Report of Two Cases

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Issue Date
2022-03
Publisher
Frontiers Media S.A.
Citation
Frontiers in Neurology, Vol.13, p. 844676
Abstract
The brain can compensate for the vestibular imbalance. When the unilateral labyrinthine function is lost, the asymmetry between the peripheral vestibular inputs is compensated centrally by readjusting the signal difference from both ears and regaining vestibular balance. If the other healthy labyrinth is destroyed, the vestibular nuclei become imbalanced again, creating spontaneous nystagmus even though there is no input to the vestibular nuclei from either labyrinth. This is called Bechterew's phenomenon; a rare and not widely recognized phenomenon that occurs in cases of bilateral sequential vestibular neuritis. This is of clinical importance because spontaneous nystagmus with bilaterally absent or diminished caloric responses may give a misleading impression of a central lesion rather than a second peripheral lesion superimposed upon the effects of central compensation for the first. Although well-documented in experimental animals, this phenomenon rarely occurs in human beings. The objective of this study is to highlight the characteristics and the progression of test results from two patients from our own experience. Along with careful history taking and physical examination, a complex interpretation of various vestibular function tests, including induced nystagmus, head impulse test, caloric test, and fundus photography, is needed to make an accurate diagnosis of bilateral sequential vestibular neuritis (BSVN).
ISSN
1664-2295
URI
https://hdl.handle.net/10371/183827
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Journal Papers (저널논문_의학과)
College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Journal Papers (저널논문_의학과)
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