Clinicopathologic Correlation in Lateral Medullary Stroke with Transient Ocular Motor Findings Mimicking Peripheral Vestibular Dysfunction (.pdf)

Unilaterally decreased horizontal vestibulo-ocular reflex (h-VOR) gain occurs with peripheral vestibular lesions or lateral pontine strokes involving the fascicle or the medial vestibular nucleus (MVN). Vestibular reflexes are typically normal in (LMS). We describe clinicopathologic findings in an unusual LMS presenting transient unidirectional nystagmus and decreased h-VOR gain, mimicking peripheral vestibulopathy (PV). The MVN neurons, close to the stroke core (ischemic penumbra), appeared pathologically normal, suggesting that the initial vestibular signs related to transient ischemia.