Isolated central vestibular syndrome.
Isolated vestibular syndrome may occur all along the vestibular pathways from the peripheral labyrinth to the brain. By virtue of recent developments in clinical neurotology and neuroimaging, however, diagnosis of isolated central vestibulopathy is increasing. Here, we review five distinct syndromes of isolated central vestibular syndrome from lesions restricted to the vestibular nuclei, the nucleus prepositus hypoglossi, the flocculus, the tonsil, and the nodulus, and introduce a new vestibular syndrome from isolated involvement of the inferior cerebellar peduncle. Decreased responses to head impulses do not exclude a central lesion as a cause of isolated vestibular syndrome. Brain imaging, including diffusion-weighted magnetic resonance imaging (MRI), may be falsely negative during the acute phase in patients with isolated vestibular syndrome because of a stroke. Central signs should be sought carefully in patients with isolated vertigo, even when the patients show the features of peripheral vestibulopathy and negative MRIs. Recognition of these isolated central vestibular syndromes would aid in defining the lesions responsible for various vestibular manifestations in central vestibulopathy.
Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Korea.
Sung-Hee
SH
Kim
Seong-Ho
SH
Park
Hyo-Jung
HJ
Kim
Ji-Soo
JS
Kim
D006801:Humans; D013577:Syndrome; D015837:Vestibular Diseases / Q000175:diagnosis / Q000503:physiopathology*; D014722:Vestibule, Labyrinth / Q000473:pathology* / Q000503:physiopathology
flocculus; inferior cerebellar peduncle; nodulus; nucleus prepositus hypoglossi; tonsil; vertigo; vestibular nucleus