Misdiagnosis of Acute Peripheral Vestibulopathy in Central Nervous Ischemic Infarction
- 1 December 2011
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Otology & Neurotology
- Vol. 32 (9), 1518-1521
- https://doi.org/10.1097/mao.0b013e318238ff9a
Abstract
Vertigo is a very common symptom at otorhinolaryngology (ENT), neurological, and emergency units, but often, it is difficult to distinguish between vertigo of peripheral and central origin. We conducted a retrospective analysis of a hospital database, including all patients admitted to the ENT University Hospital Graz after neurological examination, with a diagnosis of peripheral vestibular vertigo and subsequent diagnosis of central nervous infarction as the actual cause for the vertigo. Twelve patients were included in this study. All patients with acute spinning vertigo after a thorough neurological examination and with uneventful computed tomographic scans were referred to our ENT department. Nine of them presented with horizontal nystagmus. Only 1 woman experienced additional hearing loss. The mean diagnostic delay to the definite diagnosis of a central infarction through magnetic resonance imaging was 4 days (SD, 2.3 d). A careful otologic and neurological examination, including the head impulse test and caloric testing, is mandatory. Because ischemic events cannot be diagnosed in computed tomographic scans at an early stage, we strongly recommend to perform cranial magnetic resonance imaging within 48 hours from admission if vertigo has not improved under conservative treatment.Keywords
This publication has 24 references indexed in Scilit:
- Medullary Infarction After Vertebral Artery Dissection Presenting as Acute Peripheral VertigoOtology & Neurotology, 2011
- Isolated Vestibular Nucleus Infarction Mimicking Acute Peripheral VestibulopathyStroke, 2010
- Lagerungsschwindel bei zerebellärem NodulusinfarktDer Nervenarzt, 2009
- Evaluation of patients with acute vestibular syndromePublished by Springer Science and Business Media LLC ,2007
- Neuro-otological emergenciesCurrent Opinion in Neurology, 2007
- Cerebellar infarction presenting isolated vertigoNeurology, 2006
- Intracranial vertebral artery dissection mimicking acute peripheral vertigoActa Oto-Laryngologica, 2006
- A case of isolated nodulus infarction presenting as a vestibular neuritisJournal of the Neurological Sciences, 2004
- Vertigo and cranial nerve palsy caused by different forms of spontaneous dissections of internal and vertebral arteriesPublished by Springer Science and Business Media LLC ,2002
- Vertigo and the anterior inferior cerebellar artery syndromeNeurology, 1992