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J Korean Bal Soc > Volume 3(1); 2004 > Article
Journal of the Korean Balance Society 2004;3(1): 177-179.
전정신경 초종 환자에서 과호흡에 의해 유발된 안진 1례
, , , , , 장윤정1, 이근호1, 이창민1, 송영목1, 이정구2, 김재일1
단국대학교 의과대학 신경과학 교실, 이비인후-두경부외과학교실2
Hyperventilation Induced Nystagmus in Patient with Vestibular Schwannoma : A Case Report
Yoon Jeong Chang, Geun Ho Lee, Chang Min Lee, Young Mok Song, Chung Ku Rhee, Jae Il Kim
1Department of Neurology, Dankook University Hospital, Cheonan, Korea. taejung@dku.net
2Department of Otolaryngology-Head and Neck Surgery, Dankook University Hospital, Cheonan, Korea.
ABSTRACT
When doctors evaluate the complaints of dizziness, they often perform a series of clinical tests to look for the evidence of a vestibular dysfunction. A useful procedure is to ask the patient to take deep breaths and observe the gaze behind Frenzel goggles. If hyperventilation-induced nystagmus(HIN) is detected, it is the evidence for an underlying vestibular imbalance. The authors evaluated nystagmus with electronystagmography after hyperventilation for 50 seconds. Brain imaging was performed to search the responsible lesion for dizziness. Brain MRI revealed a brain tumor suggesting vestibular schwannoma in the left cerebellopontine angle. After hyperventilation, dizziness and the right beating horizontal nystagmus with Alexander law could be detected. By precisely measuring the HIN, we determined that inputs arising from the horizontal semicircular canal were mainly responsible. The contralaterality of the direction of the horizontal component of the nystagmus was detected. We suggest that clinicians should routinely check the nystagmus after hyperventilation, when they evaluate patients complaining of dizziness.
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