A minute demyelinating lesion causing acute positional vertigo.
Clinico-anatomical correlations in multiple sclerosis patients presenting with central positional vertigo are lacking. We report on a patient with acute onset positional vertigo mimicking benign paroxysmal positional vertigo with a single enhancing lesion in the inner part of the superior cerebellar peduncle, disclosed only after thin slice MR-imaging. This location appears to be a common cause of central positional vertigo and should be regarded as characteristic for demyelinating rather than vascular pathology. In cases presenting with positional nystagmus and vertigo without other cerebellar deficits one should look explicitly for signal abnormalities in the inner part of the superior cerebellar peduncle. High spatial resolution-MRI seems to be mandatory for lesion detection.
Anagnostou
E
E
Department of Physiology, Dizziness and Balance Unit, School of Nursing, University of Athens, Tetrapoleos Str. 8, 11527 Athens, Greece.
Varaki
K
K
Anastasopoulos
D
D
D000208:Acute Disease; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002529:Cerebellar Nuclei / Q000473:pathology; D003711:Demyelinating Diseases / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D009760:Nystagmus, Physiologic / Q000502:physiology; D014717:Vertigo / Q000188:drug therapy / Q000209:etiology*; D014722:Vestibule, Labyrinth / Q000503:physiopathology; D014839:Vomiting / Q000209:etiology
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone