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Isolated floccular infarction: impaired vestibular responses to horizontal head impulse.
MedLine Citation:
PMID:  23370610     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Isolated floccular infarction is extremely rare, and impairments of the vestibulo-ocular reflex (VOR) have not been explored in humans with isolated floccular lesions. The purpose of this study was to examine and report selective impairment of VOR in response to high acceleration using head impulse in a patient with isolated floccular infarction. The patient underwent bedside and laboratory evaluation of vestibular function, which included video-oculography, ocular torsion and the subjective visual vertical, cervical and ocular vestibular-evoked myogenic potentials, bithermal caloric irrigation, rotatory chair test, and the head impulse test (HIT) using search coils. A 70-year-old woman with a unilateral floccular infarction presented with an acute vestibular syndrome with spontaneous nystagmus beating to the lesion side, impaired ipsilesional pursuit, contraversive ocular torsion and tilt of the subjective visual vertical. With rotatory chair testing at low frequencies, horizontal VOR gains were increased. However, VOR gains were decreased with the higher-frequency, higher-speed HIT. While HIT is often normal in patients with central vestibular disorders, decreased HIT responses do not exclude an isolated cerebellar lesion as a cause of the acute vestibular syndrome.
Authors:
Hong-Kyun Park; Ji-Soo Kim; Michael Strupp; David S Zee
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-31
Journal Detail:
Title:  Journal of neurology     Volume:  -     ISSN:  1432-1459     ISO Abbreviation:  J. Neurol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-2-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Neurology, College of Medicine, Seoul National University, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, Korea.
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