A Case of Acute Vestibular Neuritis with Periodic Alternating Nystagmus
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Detection of nystagmus is an important diagnostic clue in patients with acute vertigo. Patientswith peripheral disorders exhibit nystagmus with a constant direction whereas those with centraldisorders exhibit nystagmus with changes in direction with or without gaze fixation. Periodicalternating nystagmus (PAN) is a horizontal or horizontal-rotary jerk-type nystagmus thatreverses its direction with time. PAN is typically observed in patients with central disorders,such as cerebellar or pontomedullary lesions, but it is also observed in patients with peripheraldisorders, albeit rarely. Here we report a rare case of a 58-year-old patient with vertigo withPAN, which was initially suspected as a central disorder, but eventually diagnosed as a peripheralvestibular disorder. We investigated the characteristics and mechanisms of peripheral PANin this case. The absence of central disorder symptoms, visual suppression of PAN, normal oculomotorfindings, and transient persistence are important diagnostic clues for differentiatingperipheral from central PAN
Abstract
Detection of nystagmus is an important diagnostic clue in patients with acute vertigo. Patientswith peripheral disorders exhibit nystagmus with a constant direction whereas those with centraldisorders exhibit nystagmus with changes in direction with or without gaze fixation. Periodicalternating nystagmus (PAN) is a horizontal or horizontal-rotary jerk-type nystagmus thatreverses its direction with time. PAN is typically observed in patients with central disorders,such as cerebellar or pontomedullary lesions, but it is also observed in patients with peripheraldisorders, albeit rarely. Here we report a rare case of a 58-year-old patient with vertigo withPAN, which was initially suspected as a central disorder, but eventually diagnosed as a peripheralvestibular disorder. We investigated the characteristics and mechanisms of peripheral PANin this case. The absence of central disorder symptoms, visual suppression of PAN, normal oculomotorfindings, and transient persistence are important diagnostic clues for differentiatingperipheral from central PAN
참고문헌 (12)
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