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Video Report
소뇌교뇌각 신경초종을 동반한 Brun 안진
홍슬기, 박지윤orcid, 최승진, 김민지
Brun’s Nystagmus with Cerebellopontine Angle Schwannoma
Seulgi Hong, Ji-Yun Parkorcid, Seungjin Choi, Min Jee Kim
Research in Vestibular Science 2023;22(2):57-58.
DOI: https://doi.org/10.21790/rvs.2023.22.2.57
Published online: June 15, 2023

Department of Neurology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Korea

Corresponding Author: Ji-Yun Park Department of Neurology, Ulsan University Hospital, Ulsan University College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 44033, Korea Tel: +82-32-621-6475, Fax: +82-52-250-7088, E-mail: lullu21@hanmail.net; bingbing@uuh.ulsan.kr
• Received: June 1, 2023   • Revised: June 2, 2023   • Accepted: June 3, 2023

Copyright © 2023 by The Korean Balance Society.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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A 70-year-old woman with trigeminal cystic schwannoma developed imbalance and dizziness over a year and a half. Neurologic examination revealed mild abduction limitation of the right eye and positive head impulse test toward the rightward and right peripheral facial palsy.
Videooculography showed a large-amplitude right-beating nystagmus with the rightward gaze and a small-amplitude left-beating nystagmus with the leftward gaze (Supplementary Video 1). Brain magnetic resonance imaging with enhancement demonstrated a well-defined huge mass (about 7×4 cm) in the right cerebellopontine angle compressing the middle cerebellar peduncle and pons (Fig. 1).
Brun’s nystagmus is a combination of ipsilesional gaze-evoked nystagmus with decreasing velocity waveform and contralesional gaze-induced vestibular nystagmus with linear velocity waveform [1]. The ipsilesional large-amplitude slow nystagmus is the result of impairment of gaze holding due to compression or ischemia of the horizontal neural integrator [2]. The contralesional small-amplitude fast nystagmus is caused by the impairment of the ipsilateral vestibular system. Since this rare directional changing nystagmus indicates localization and lateralization of a lesion, we must know the clinical meaning of this.

CONFLICT OF INTEREST

Ji-Yun Park is the Editor-in-Chief of Research in Vestibular Science and was not involved in the review process of this article. All authors have no other conflicts of interest to declare.

FUNDING/SUPPORT

None.

AUTHOR CONTRIBUTIONS

Conceptualization: SGH, JYP; Data curation: SGH; Formal analysis: SGH, JYP; Investigation: SGH; Methodology: JYP; Project administration: SJC, MJK; Supervision : SGH, JYP; Visualization: SJC, MJK; Writing–Original Draft: SGH, JYP; Writing–Review & Editing: All authors.

All authors read and approved the final manuscript.

Supplementary Video 1 can be found via https://doi.org/10.21790/rvs.2023.22.2.57. Videooculography showed a largeamplitude right-beating nystagmus with the rightward gaze and a small-amplitude left-beating nystagmus with the leftward gaze. Written informed consent was obtained for publication of this report and accompanying video.
Fig. 1.
Brain magnetic resonance imaging with enhancement demonstrated a well-defined huge mass (about 7×4 cm) in the right cerebellopontine angle compressing the middle cerebellar peduncle and pons. The mass is high signal intensity on the T2-weighted image (A) and low signal intensity with mild ring enhancement on the T1-weighted images (B, C).
rvs-22-2-57f1.jpg
  • 1. Leigh RJ, Zee D S. The neurology of eye movements. 5th ed. Oxford (UK): Oxford University Press; 2015.
  • 2. Mantokoudis G, Korda A, Zee D S, Zamaro E, Sauter TC, Wagner F, et al. Bruns' nystagmus revisited: a sign of stroke in patients with the acute vestibular syndrome. Eur J Neurol 2021;28:2971–9.ArticlePubMedPMCPDF

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        Brun’s Nystagmus with Cerebellopontine Angle Schwannoma
        Res Vestib Sci. 2023;22(2):57-58.   Published online June 15, 2023
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