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Research in Vestibular Science > Accepted Articles
Gaze-evoked and Perverted Head-Shaking Nystagmus In a Patient with Polycythemia Vera
Yongsoo Kim1, Ik-Chan Song2, Seong-Hae Jeong1, Ae Young Lee1, Jae Moon Kim1
1Department of Neurology, Chungnam National University Hospital, Daejeon, Korea
2Division of Hematology/Oncolgy, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
3Department of Neurology, Ulleung-gun Health center and Country Hospital, Ulleung-gun, Korea
Correspondence  Seong-Hae Jeong ,Tel: 042-280-8057, Fax: --, Email: mseaj@hanmail.net
Received: November 8, 2017;  Accepted: November 27, 2017.  Published online: November 27, 2017.
ABSTRACT
Polycythemia vera (PV) is well known chronic myeloproliferative neoplasm, caused by clonal expansion of an abnormal hematopoietic stem cell. Patients with PV may present diverse neurologic symptoms including headache, dizziness or vertigo, tinnitus. However, the attention has not been directed to the neuro-otological findings in patients with PV. Here, we present a 71-year-old male patient with PV suffered from vertigo and headache. He demonstrated gaze-evoked nystagmus and perverted head shaking nystagmus. Transcranial Doppler showed decrement of blood flow velocity in posterior circulation. The patient’s neuro-otologic findings were normalized as polychethemia and blood flow improved with repetitive phlebotomy and medications such as hydroxyurea and aspirin. Considering the neurological and hemodynamic findings in our patient, the mechanism of vertigo in PV could be explained by central vestibulopathy because of vascular insufficiency rather than peripheral vestibulopathy because of inner ear blood hyperviscosity.
Keywords: Nystagmus; Vertigo; Polycythemia Vera; Transcranial Doppler
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