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Research in Vestibular Science > Volume 11(0); 2012 > Article
Research in Vestibular Science 2012;11(0): 85-88.
급성 자발 현훈
부산대학교 의과대학 신경과학교실
Acute Spontaneous Vertigo
Kwang-Dong Choi, MD
Department of Neurology, Pusan National University Hospital, Busan, Korea
Vertigo is an illusion of rotation, which results from an imbalance within the vestibular system. Acute spontaneous vertigo is the rapid onset of vertigo, nausea, and vomiting (with nystagmus, unsteady gait, and head motion intolerance) over seconds-hours, lasting days-weeks. Common causes of acute spontaneous vertigo include vestibular neuritis, labyrinthitis, and brainstem or cerebellar stroke. An acute central vestibulopathy resulting from lesions affecting the pons (the root entry zone of the vestibular nerve, vestibular fascicle, vestibular nucleus), inferior cerebellum (uvula and nodulus), or vestibular cortex (insula) can mimick peripheral vestibular disorder (pseudo-vestibular neuritis). It is important to differentiate central vestibulopathy from acute spontaneous vertigo, because it can produce cerebellar swelling that can lead to brainstem compression and death unless there is neurosurgical intervention. The history and detailed neurological/neurotological examinations usually provides the key information for distinguishing between acute peripheral and central vestibulopathy. Brain MRI is indicated in any patient with acute spontaneous vertigo accompanied by no improvement within 48 hours, abnormal neurological signs, severe headache, profound postural imbalance, unilateral hearing loss, normal head impulse test, and central patterns on vestibular function tests.
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