A Case of Pseudo-Vestibular Neuritis with Contralesional Canal Paresis due to Spontaneous Bilateral Vertebral Artery Dissection / 대한이비인후과학회지

ABSTRACT

Pseudo-vestibular neuritis is a central pathology of acute vestibular syndrome, characterized by unidirectional nystagmus mimicking acute peripheral vestibulophaty. We report a 39-year-old female patient who developed cerebellar infarction with isolated vertigo, spontaneous nystagmus, a positive head thrust test, and unilateral canal paresis in the contralesional side. The patient had no vascular risk factors. A diffusion-weighted image of the brain showed infarction of medial branch of posterior inferior and superior cerebellar artery on the left side. A magnetic resonance angiography of neck disclosed a wide range of diffused severe stenosis and narrowing of right and left vertebral arteries, respectively. This case suggests the possibility of vestibular ischemia masking the central pathology in isolated vertigo.