The acute vestibular syndrome in MS due to middle cerebellar peduncle/root entry zone lesion

Update item information
Identifier AVS_in_MS
Title The acute vestibular syndrome in MS due to middle cerebellar peduncle/root entry zone lesion
Subject Jerk nystagmus; Vestibular nystagmus; Vestibulo-ocular reflex; Head impulse testing; Gaze-evoked nystagmus
Creator Daniel R. Gold, DO, Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine
Description This is a 13 year-old girl with relatively abrupt onset vertigo and oscillopsia. On exam, there was primarily right-beating nystagmus in primary gaze with a slight upward (upbeat) component, giving the nystagmus an oblique appearance. The upward component and lack of a clear torsional component acutely makes the nystagmus atypical for a peripheral localization despite a + head impulse test to the left side. Furthermore, her nystagmus was direction changing (gaze-evoked): right-beating in right and down, left-beating in left, up-beating in up. Her acute demyelinating lesion was at the middle cerebellar pendulce and there appeared to be some of the intraparenchymal portion of the 8th cranial nerve, head impulse test (HIT), which generally (but not always) suggests a peripheral localization. While a negative HIT is highly suggestive of a central etiology in the acute vestibular syndrome, a + HIT can be either peripheral or central.
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2016
Type Image/MovingImage
Format video/mp4
Rights Management Copyright 2016. For further information regarding the rights to this collection, please visit:
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s6n04g7v
Setname ehsl_novel_gold
Date Created 2016-08-30
Date Modified 2017-12-06
ID 187728
Reference URL
Back to Search Results