Abnormal Head Impulse Test in a Unilateral Cerebellar Lesion
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Background The fndings 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. Te 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 focculus. ConclusionszThis case provides additional evidence that damage to the focculus or its connections may impair the vestibulo-ocular refex only during high-speed stimuli, especially when the stimuli are applied to the contralesional side. By observing accompanying cerebellar signs, the abnormal HIT fndings caused by a cerebellar disorder can be distinguished from those produced by peripheral vestibular disorders.
Abstract
Background The fndings 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. Te 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 focculus. ConclusionszThis case provides additional evidence that damage to the focculus or its connections may impair the vestibulo-ocular refex only during high-speed stimuli, especially when the stimuli are applied to the contralesional side. By observing accompanying cerebellar signs, the abnormal HIT fndings caused by a cerebellar disorder can be distinguished from those produced by peripheral vestibular disorders.
참고문헌 (20)
- Halmagyi GM, "A clinical sign of canal paresis", Arch Neurol, 45, pp.737~739 (1988)
- Kattah JC, "HINTS to diagnose stroke in the acute vestibular syndrome: threestep bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging", Stroke, 40, pp.3504~3510 (2009)
- Kremmyda O, "Strupp M. False-positive head-impulse test in cerebellar ataxia", Front Neurol, 3, pp.162~ (2012)
- Park HK, "Isolated floccular infarction:impaired vestibular responses to horizontal head impulse", J Neurol, 260, pp.1576~1582 (2013)
- Leigh RJ, "The neurology of eye movements" (2006), Oxford University Press
- Lisberger SG, "Signals used to compute errors in monkey vestibuloocular reflex: possible role of flocculus", J Neurophysiol, 52, pp.1140~1153 (1984)
- Robinson DA, "Adaptive gain control of vestibuloocular reflex by the cerebellum", J Neurophysiol, 39, pp.954~969 (1976)
- Schultheis LW, "Directional plasticity of the vestibuloocular reflex in the cat", Ann N Y Acad Sci, 374, pp.504~512 (1981)
- Zee DS, "Effects of ablation of flocculus and paraflocculus of eye movements in primate", J Neurophysiol, 46, pp.878~899 (1981)
- Fernandez C, "Physiology of peripheral neurons innervating semicircular canals of the squirrel monkey. II. Response to sinusoidal stimulation and dynamics of peripheral vestibular system", J Neurophysiol, 34, pp.661~675 (1971)
- Pulaski PD, "The behavior of the vestibulo-ocular reflex at high velocities of head rotation", Brain Res, 222, pp.159~165 (1981)
- Raymond JL, "Neural learning rules for the vestibuloocular reflex", J Neurosci, 18, pp.9112~9129 (1998)
- Tabata H, "Computational study on monkey VOR adaptation and smooth pursuit based on the parallel control-pathway theory", J Neurophysiol, 87, pp.2176~2189 (2002)
- Leung HC, "Cerebellar flocculus and paraflocculus Purkinje cell activity during circular pursuit in monkey", J Neurophysiol, 83, pp.13~30 (2000)
- Glasauer S, "Up-down asymmetry of cerebellar activation during vertical pursuit eye movements", Cerebellum, 8, pp.385~388 (2009)
- Belknap DB, "Eye movements evoked by microstimulation in the flocculus of the alert macaque", Exp Brain Res, 67, pp.352~362 (1987)
- Büttner-Ennever JA, "Pathways from cell groups of the paramedian tracts to the floccular region", Ann N Y Acad Sci, 781, pp.532~540 (1996)
- Cheron G, "Discharge properties of brain stem neurons projecting to the flocculus in the alert cat. I. Medical vestibular nucleus", J Neurophysiol, 76, pp.1759~1774 (1996)
- Escudero M, "Discharge properties of brain stem neurons projecting to the flocculus in the alert cat. II. Prepositus hypoglossal nucleus", J Neurophysiol, 76, pp.1775~1785 (1996)
- Zee DS, "Cerebellar control of ocular gaze stability", Ann Neurol, 7, pp.37~40 (1980)