[Antiphospholipid antibodies in patients with vestibular manifestations. A study of 16 cases].
BACKGROUND
Antiphospholipid antibodies lupus anticoagulant (LA) and anticardiolipin antibodies (aCL) play a role in promoting arterial and venous thrombosis in several vascular territories. Acute vestibular syndromes are a common complaint in general and neurology practice. Approximately 9% of cases are due to central nervous system vestibular areas lesions, often associated with vascular disorders.


OBJECTIVE
Define the potential relationship between these antibodies and central or peripheral vestibular failure.


METHODS
We report the presence of antiphospholipid antibodies in 16 patients with central vestibular symptoms. All patients were seen in the Neuro otology and Vascular Neurology clinics at the Institute for Neurological Research in Buenos Aires. Magnetic resonance imaging (MRI) and ancillary neuro otologic tests were used to determine the etiology of vestibular manifestations. Determinations of LA and aCL were done using standard criteria.


RESULTS
We evaluated 16 patients (13 women and 3 men), aged 44 4 years (21 65). Thirteen patients did not have stroke risk factors. MRI lesions were found in 11 subjects (1 cerebellar infarct, 3 pontine ischemic changes, and 9 white matter abnormalities). All patients had signs consistent with dysfunction of vestibulo cerebellar structures or the vestibular nuclei. All patients had positive LA and 4 of them had also elevated aCL.


CONCLUSIONS
Our findings suggest a potential association between the presence of a prothrombotic state and central vestibular dysfunction of vascular etiology. To the best of our knowledge, this is the first report of such an association in the absence of clinically evident autoimmune disease.
López-Gentili
L I
LI
Departamento de Neuro-Olotogía, Instituto ENERI, Hospital Ramos Mejia, Buenos Aires, Argentina. lucrecia@lvd.com.ar
Garate
G
G
Riveros
D
D
Ameriso
S F
SF
D000328:Adult; D000368:Aged; D017153:Antibodies, Anticardiolipin / Q000378:metabolism; D017152:Antibodies, Antiphospholipid / Q000378:metabolism*; D005260:Female; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014652:Vascular Diseases / Q000276:immunology* / Q000473:pathology; D015837:Vestibular Diseases / Q000276:immunology* / Q000473:pathology; D014726:Vestibular Nuclei / Q000473:pathology*
D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D016682:Lupus Coagulation Inhibitor