Value of Tc-99m HMPAO SPECT in Differential Diagnosis of Vertigo: with special reference to the diagnosis of vertebrobasilar insufficiency

ABSTRACT

To evaluate the possible potential of Tc-99m HMPAO SPECT in the differential diagnosis of vertigo, we selected 23 patients and devided them into three groups according to their clinical manifestations vestibuloneuronitis(VN), benign positional vertigo(BPV), and vertebrobasilar insufficiency (VBI) groups. Then, we prospectively performed SPECT in these patients. In addition, risk factors for strokes, Nylan-Barany tests, brain stem auditory evoked responses(BAER) were investigated. Perfusion defects in the vertebrobasilar territory were evident in 7 out of 8 cases in VBI group, while 1 out of 5, and 2 out of 10 cases showed such findings in BPV and VN groups respectively. We conclude that SPECT may play a role in differential diagnosis of vertigo. It also seems more useful than traditional investigations such as CT, MRI, or BAER in the evaluation of the patients with VBI.