Research in Vestibular Science

Ocular Flutter in Parainfectious Meningoencephalitis: A Case Report: In-Ho Yoon, Seung-Hoon Yun, Bong-Hui Kang; Res Vestib Sci. 2021;20(3):113-117. Published online September 15, 2021; DOI: https://doi.org/10.21790/rvs.2021.20.3.113

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Abstract PDF Supplementary Material: Ocular flutter is a rare, horizontal eye movement disorder characterized by intermittent bursts of conjugate horizontal saccades without intersaccadic intervals. It can occur in various clinical conditions such as metabolic dysfunction, infection and paraneoplastic syndrome. Herein, a 50-year-old male showed ocular flutter in parainfectious meningoencephalitis and immunoglobulin therapy led to an improvement of symptoms. This case can improve the understanding of the pathological mechanisms of ocular flutter.

Opsoclonus-Myoclonus Syndrome Associated with Scrub Typhus: You Jin Choi, Seo Young Choi, Jae-Hwan Choi, Kwang-Dong Choi; Res Vestib Sci. 2017;16(1):34-37. Published online March 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.1.34

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Scrub typhus is an infective acute febrile disorder caused by the intracellular parasite Orientia tsutsugamushi. Neurological manifestations of scrub typhus are meningoencephalitis, cerebellitis, transverse myelitis, papilledema, and cranial nerve palsy. However, opsoclonus-myoclonus syndrome associated with scrub typhus has been rarely reported. A 59-year-old man developed vertigo, nausea, vomiting, and imbalance following scrub typhus infection for eight days. Examination showed eschar at the axilla, decreased mentality, and opsoclonus- myoclonus syndrome. Video-oculography disclosed opsoclonus with an amplitude of 15°–20° and a frequency of 6–8 Hz. The serum antibody titers to Orientia tsutsugamushi were 1:5,120, and cerebrospinal fluid analysis revealed pleocytosis. Brain magnetic resonance imaging was normal. Neurological symptoms and signs completely improved by systemic steroid and antibiotics treatment. Various mechanisms including direct disseminating inflammation or indirect immune modulation may give rise to neurological complications following scrub typhus.

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Scrub typhus meningoencephalitis presenting as opsoclonus myoclonus syndrome: A video-based case
Laxmikant Ramkumarsingh Tomar, Dhrumil Jatinbhai Shah, Utkarsh Agarwal, Atul Gogia, Anshu Rohatgi, CS Agrawal
Tropical Doctor.2022; 52(1): 192. CrossRef
Neurological Manifestations of Scrub Typhus
Sagar Basu, Ambar Chakravarty
Current Neurology and Neuroscience Reports.2022; 22(8): 491. CrossRef
Neurological facets of scrub typhus: A comprehensive narrative review
Divyani Garg, Abi Manesh
Annals of Indian Academy of Neurology.2021; 24(6): 849. CrossRef

Rapidly Progressive Ophthalmoplegia and Brainstem-Cerebellar Dysfunction in Rhombencephalitis Caused by Listeria monocytogenes: Sung-Sik Kim, Jong-Hun Kim, Jin-Heui Lee, Seung-Han Lee; Res Vestib Sci. 2017;16(1):29-33. Published online March 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.1.29

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Abstract PDF: Listeria monocytogenes (L. monocytogenes) is a rare, but important bacterial pathogen causing central nervous system infection in the elderly, pregnant women, and immunocompromised patients. A 60-year-old man with diabetes presented with headache, fever and rapidly progressive ophthalmoplegia. Based on serological and MRI studies, he was diagnosed with rhombencephalitis due to L. monocytogenes. The patient recovered without complications with urgent initiation of empirical antibiotics and the pathogen-specific antibiotic treatment. L. monocytogenes should be considered as a cause of rhombencephalitis presenting as external ophthalmoplegia.

Herpes Simplex Encephalitis Suffered Rotatory Dizziness as a Primary Symptom: Sun A Choi, Jae Yong Byun, Sun Kyu Lee; Res Vestib Sci. 2013;12(2):67-71.

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Abstract: Herpes simplex encephalitis (HSE) is rare, serious sporadic encephalitis associated with high mortality in untreated cases. Although cognitive impairment with fever could be the clue of diagnosis, various symptoms can make it difficult to be diagnosed. Dizziness is one of the most frequent symptoms ENT doctors can encounter. Authors experienced the HSE patient suffered rotatory sense of dizziness as a primary symptom and treated the patient successfully without major complication. We reported our experience and findings of vestibular function test of patient. It could be helpful to other ENT doctors who encounter similar patients.

Two Cases of Methyl Bromide Intoxication Mimicking Bickerstaff’s Brainstem Encephalitis: Jin Young Seo, Byoung Soo Shin, Man Wook Seo, Young Hyun Kim, Sun Young Oh; J Korean Bal Soc. 2008;7(2):199-203.

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Abstract PDF: Background: Methyl bromide is toxic to the central and peripheral nervous systems. Two patients with occupational exposure to this agent are described. Case: Two cases of previously healthy young men were involved. They had worked in a fumigating plant spraying fruits using methyl bromide for several months before admission. They showed general weakness, severe ataxia, bilateral dysmetria and bilateral lateral gaze limitation. And gaze-evoked nystagmus was observed in one of them. Brain MRI showed symmetrically increased signal intensity lesions including the brainstem, cerebellum and splenium of corpus callosum. After conservative treatment, they gradually improved over the next few weeks. Conclusions: Symmetry and topography of our patients’ clinical and radiographic abnormalities support the proposal that methyl bromide exposure can produce symptoms similar to Bickerstaff’s brainstem encephalitis. Key words: Methyl bromide, Acute intoxication, Bickerstaff’s brainstem encephalitis

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