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Research in Vestibular Science > Volume 13(2); 2014 > Article
Research in Vestibular Science 2014;13(2): 57-62.
원지성 방향전환성 두위안진을 보이는 중추성 어지럼 2예
박민철, 박진수, 김민범, 반재호
성균관대학교 의과대학 강북삼성병원 이비인후-두경부외과학교실
Two Cases of Central Vertigo Presenting as Apogeotropic Direction Changing Positional Nystagmus
Min Chul Park, Jin Su Park, Min Beom Kim, Jae Ho Ban
Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. miphy87@naver.com
ABSTRACT
Positional vertigo and nystagmus without focal neurological symptoms and signs are characteristic features of benign paroxysmal positional vertigo (BPPV). And the apogeotropic positional nystagmus can be diagnosed as cupulolithiasis of the horizontal semicircular canal. However, cerebellar lesion involving especially nodulus could be initially presented as positional vertigo like a BPPV without other neurologic signs. In most of the patients with cerebellar involvement, initial presentation shows dysarthria, ataxia, headache, nausea, vomiting and unsteadiness. But in some central lesions, positional nystagmus might be observed in head roll test as if BPPV was presented. It is very important for clinicians of dizziness care unit to differentiate central positional vertigo (CPV) from BPPV. But it is difficult to diagnose CPV at initial visit by history and physical exam only. Therefore, we introduce two cases with cerebellar infarction and hemorrhage initially presenting isolated positional vertigo mimicking BPPV.
Keywords: Cerebellum; Brain infarction; Benign paroxysmal positional verigo
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