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Head-Shaking Aids in the Diagnosis of Acute Audiovestibular Loss due to Anterior Inferior Cerebellar Artery Infarction.
MedLine Citation:
PMID:  23296146     Owner:  NLM     Status:  Publisher    
Objective: To determine the patterns and diagnostic value of head-shaking nystagmus (HSN) in patients with acute audiovestibular loss. Method: Eighteen patients underwent evaluation of spontaneous nystagmus, gaze-evoked nystagmus, HSN, head impulse test, ocular tilt reaction, subjective visual vertical, bithermal caloric tests, and pure-tone audiogram. The findings were compared with those of 21 patients with labyrinthitis. Results: Fifteen patients (83%) exhibited HSN, and the horizontal HSN usually beat contralesionally (10/14, 71%). However, 9 (50%) patients also showed patterns of central HSN that included perverted HSN (n = 7), HSN in the opposite direction of spontaneous nystagmus (n = 4), and HSN beating towards unilateral canal paresis or abnormal head impulse testing (n = 3). Overall, central HSN, gaze-evoked nystagmus, and normal head impulse testing were specific for anterior inferior cerebellar artery (AICA) infarction. Moreover, central HSN was the only sign that indicated stroke in 1 of our patients with isolated audiovestibular syndrome. Lesion subtraction analyses revealed that damage to the flocculus was relatively frequent in patients with perverted HSN. Conclusions: In AICA infarction, HSN was common with both peripheral and central patterns. Careful evaluation of HSN may provide clues for AICA infarction in patients with acute audiovestibular loss.
Young Eun Huh; Ja-Won Koo; Hyung Lee; Ji-Soo Kim
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-28
Journal Detail:
Title:  Audiology & neuro-otology     Volume:  18     ISSN:  1421-9700     ISO Abbreviation:  Audiol. Neurootol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2013-1-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9606930     Medline TA:  Audiol Neurootol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  114-124     Citation Subset:  -    
Copyright Information:
Copyright © 2012 S. Karger AG, Basel.
Department of Neurology, Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, South Korea.
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