Research in Vestibular Science

Vestibular Migraine: A Recent Update on Diagnosis and Treatment: Young Seo Kim, Hak Seung Lee; Res Vestib Sci. 2022;21(3):67-74. Published online September 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.3.67

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Abstract PDF: Vestibular migraine (VM) is a variant of migraine resulting in vestibular symptoms in addition to symptoms typical of migraine. However, without a biomarker or a complete understanding of the pathophysiology, VM remains underrecognized and underdiagnosed. Therefore, the diagnosis of VM is still challenging. Meanwhile, VM should be clearly differentiated from other similar diseases. Here, we highlight these challenges, discuss common vestibular symptoms and clinical presentations in VM, and review the current aspects of its clinical diagnosis and evaluation. The concepts related to the treatment of VM are also discussed.

Ponto-medullary Junction Infarction Presenting as Ipsilateral Abducens Nerve Palsy and Contralateral Hemiparesis without Facial Involvement: Ji Hun Lim, Young Seo Kim, Hak Seung Lee; Res Vestib Sci. 2019;18(4):118-121. Published online December 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.4.118

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Raymond syndrome is a pontine syndrome consisting of ipsilateral abducens nerve palsy, contralateral facial paralysis, and contralateral hemiparesis. However, subsequent clinical observations argued on the presentation of facial involvement. The only differentiating point between the facial including called classic type and the facial sparing Raymond syndrome is the location of the lesion. The classic type involves abducens nerve, corticofacial, and corticospinal tracts; while in the facial sparing type, corticofacial tracts, and peripheral facial nerves are spared. We experienced a 78-year-old man presented with sudden onset dizziness, binocular horizontal diplopia, and right-sided motor weakness. Neurological examination showed he had left abducens nerve palsy and right hemiparesis without facial involvement. Brain magnetic resonance imaging showed acute ischemic infarction in the left ponto-medullary junction. Regardless of the presence or absence of facial palsy, the combination of abducence nerve palsy and contralateral hemiparesis should direct the clinician’s attention towards the medial ventral caudal ponto-medullary junction.

Citations

Citations to this article as recorded by

Pontine ischaemic stroke syndromes
Marcus Ground, Martin N M Punter, Ian Rosemergy
Practical Neurology.2023; 23(6): 501. CrossRef
An Atypical Radiologic Presentation of Right Sixth Lateral Rectus Palsy: A Case Report
Anicia Mirchandani, Sheena Saleem, Lalitha Sivaswamy
Cureus.2022;[Epub] CrossRef

Dizziness after Traumatic Brain Injury: Neurological Aspects: Young Seo Kim, Seon Jae Im, Hak Seung Lee; Res Vestib Sci. 2019;18(3):59-63. Published online September 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.3.59

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Abstract PDF: Vertigo, dizziness, and disequilibrium are common symptoms following concussion or traumatic brain injury. Dizziness and vertigo may be the result of trauma to the peripheral vestibular system or the central nervous system, or, in some cases, may be due to anxiety, depression, or posttraumatic stress disorder; these mechanisms are not mutually exclusive. While most peripheral vestibular disorders can be identified by testing and examination, those without inner ear causes that have persisting complaints of dizziness and motion sickness are more difficult to understand and to manage. Some of these patients exhibit features compatible with vestibular migraine and may be treated successfully with migraine preventative medications. This paper reviews the neurological causes of persisting dizziness, the possible mechanisms, and the pathophysiology, as a framework for patient management and for future research.

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