Skip to main content
SpringerLink
Log in

Zentrale vestibuläre Schwindelformen

  • Chapter
Vertigo

  • 72 Accesses

Zusammenfassung

Zentrale vestibuläre Schwindelformen entstehen durch Läsionen entlang der vestibulären Verbindungen von den Vestibulariskernen in der Medulla oblongata zu den okulomotorischen Kernen und Integrationszentren im rostralen Mittelhirn sowie zum Vestibulozerebellum, Thalamus und vestibulären Kortex im temporoparietalen Großhirn (Brandt und Dieterich 1995). Es handelt sich oft um klar definierte klinische Syndrome unterschiedlicher Ätiologie, deren typische Befunde aus Okulomotorik, Wahrnehmung und Haltungsregulation eine topische Hirnstammdiagnostik erlauben. Die Analyse des Nystagmus kann für die lokalisatorische Zuordnung hilfreich sein (Büttner et al. 1995). Auf diese typischen Befunde soll hier eingegangen werden. Zentrale vestibuläre Syndrome können je nach Größe der Läsion isoliert vorkommen oder aber Teil eines komplexen infratentoriellen Syndroms sein, wobei als weitere Symptome supranukleäre oder nukleare Okulomotorikstörungen und/oder weitere neurologische Hirnstammausfälle vorkommen (z.B. Wallenberg-Syndrom mit „ocular tilt reaction“ sowie Horner-Syndrom, Sensibilitätsstörungen, Ataxie, Gaumensegelparese, Dysarthrophonie und Dysphagie).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  • Averbuch-Heller L, Tusa RJ, Fuhry L, Rottach KG, Ganser GL, Heide W, Büttner U, Leigh RJ (1997) A double-blind controlled study of gabapentin and baclofen as treatment for acquired nystagmus. Ann Neurol 41:818–825

    Article  PubMed  CAS  Google Scholar 

  • Baloh RW, Jacobson K, Honrubia V (1993) Horizontal semicircular canal variant of benign positional vertigo. Neurology 43:2542–2549

    Article  PubMed  CAS  Google Scholar 

  • Baloh RW, Spooner JW (1981) Downbeat nystagmus. A type of central vestibular nystagmus. Neurology 31:304–310

    Article  PubMed  CAS  Google Scholar 

  • Baloh RW, Yee RD (1989) Spontaneous vertical nystagmus. Rev Neurol 145:527 – 532

    PubMed  CAS  Google Scholar 

  • Brandt T, Dieterich M (1994) Vestibular syndromes in the roll plane: Topographic diagnosis from brainstem to cortex. Ann Neurol 36:337–347

    Article  PubMed  CAS  Google Scholar 

  • Brandt T, Dieterich M (1995) Central vestibular syndromes in roll, pitch, and yaw planes. Topographic diagnosis of brainstem disorders. Neuroophthalmology 15:291–303

    Article  Google Scholar 

  • Brandt T, Dieterich M, Danek A (1994) Vestibular cortex lesions affect the perception of verticality. Ann Neurol 35:528–534

    Article  Google Scholar 

  • Büttner U, Helmchen C, Büttner-Ennever JA (1995) The localizing value of nystagmus in brainstem disorders. Neuroophthalmology 15:283–290

    Article  Google Scholar 

  • Büttner-Ennever JA, Horn AKE, Schmidtke K (1989) Cell groups of the medial longitudinal fasciculus and paramedian tracts. Rev Neurol 145:533–539

    PubMed  Google Scholar 

  • Cox TA, Corbett JJ, Thompson S et al (1981) Upbeat nystagmus changing to downbeat nystagmus with convergence. Neurology 31:891–892

    Article  PubMed  CAS  Google Scholar 

  • DeJong JMBV, Cohen B, Matsuo V, Uemura T (1980) Midsagittal pontomedullary brainstem section: effects on ocular adduction and nystagmus. Exp Neurol 68:420–442

    Article  CAS  Google Scholar 

  • Dichgans M, Dieterich M (1995) Third nerve palsy with contralateral ocular torsion and binocular tilt of visual vertical, indicating a midbrain lesion. Neuroophthalmology 15:315–320

    Article  Google Scholar 

  • Dieterich M, Brandt T (1992) Wallenberg’s syndrome: Lateropulsion, cyclorota-tion, and subjective visual vertical in thirty-six patients. Ann Neurol 31:399–408

    Article  PubMed  CAS  Google Scholar 

  • Dieterich M, Brandt T (1993 a) Ocular torsion and tilt of subjective visual vertical are sensitive brainstem signs. Ann Neurol 33:292–299

    Article  PubMed  CAS  Google Scholar 

  • Dieterich M, Brandt T (1993 b) Thalamic infarctions: Differential effects on vestibular function in roll plane (35 patients). Neurology 43:1732–1740

    Article  PubMed  CAS  Google Scholar 

  • Dieterich M, Brandt T (1993 c) Ocular torsion and perceived vertical in oculomotor, trochlear and abducens nerve palsies. Brain 116:1095–1104

    Article  PubMed  Google Scholar 

  • Dieterich M, Grünbauer M, Brandt T (1998) Direction-specific impairment of motion perception and spatial orientation in downbeat and upbeat nystagmus in humans. Neurosci Lett 245:29–32

    Article  PubMed  CAS  Google Scholar 

  • Dieterich M, Straube A, Brandt T, Paulus W, Büttner U (1991) The effects of baclofen and cholinergic drugs on upbeat and downbeat nystagmus. J Neurol Neurosurg Psychiatry 54:627–632

    Article  PubMed  CAS  Google Scholar 

  • Glasauer S, Hoshi M, Kempermann U, Eggert T, Büttner U (2003) Three-dimensional eye position and slow phase velocity in humans with downbeat nystagmus. J Neurophysiol 89:338–354

    Article  PubMed  CAS  Google Scholar 

  • Helmchen C, Rambold H, Fuhry L, Büttner U (1998) Deficits in vertical and torsional eye movements after uni- and bilateral muscimol inactivation of the interstitial nucleus of Cajal of the alert monkey. Exp Brain Res 119:436–452

    Article  PubMed  CAS  Google Scholar 

  • Janssen JC, Larner AJ, Morris H, Bronstein AM, Farmer SF (1998) Upbeat nystagmus: clinicoanatomical correlation. J Neurol Neurosurg Psychiatry 65:380–381

    Article  PubMed  CAS  Google Scholar 

  • Kattah JC, Dagi TF (1990) Compensatory head tilt in upbeating nystagmus. J Clin Neuroophthalmol 10:27–31

    Article  PubMed  CAS  Google Scholar 

  • Nakada T, Remler MP (1981) Primary position upbeat nystagmus. J Clin Neuro-ophthlmol 1:185–189

    CAS  Google Scholar 

  • Ranalli RJ, Sharpe JA (1988) Upbeat nystagmus and the ventral tegmental pathway of the upward vestibulo-ocular reflex. Neurology 38:1329–1330

    Article  PubMed  CAS  Google Scholar 

  • Strupp M, Schüler O, Krafczyk S, Jahn K, Schautzer F, Büttner U, Brandt T (2003) Treatment of downbeat nystagmus with 3,4-diaminopyridine — a placebo-controlled study. Neurology 61:165–170

    Article  PubMed  CAS  Google Scholar 

  • Zee DS, Yamazaki A, Butler PH, Gücer F (1981) Effects of ablation of flocculus and paraflocculus on eye movements in primate. J Neurophysiol 46:878–899

    PubMed  CAS  Google Scholar 

  • Bickerstaff ER (1961) Basilar artery migraine. Lancet 1:15–17

    Article  Google Scholar 

  • Cutrer FM, Baloh RW (1992) Migraine-associated dizziness. Headache 32:300–304

    Article  PubMed  CAS  Google Scholar 

  • Dieterich M, Brandt Th (1999) Episodic vertigo related to migraine (90 cases): vestibular migraine? J Neurol 246:883–892

    Article  PubMed  CAS  Google Scholar 

  • Goadsby PJ (2000) The pharmacology of headache. Prog Neurobiol 62:509–525

    Article  PubMed  CAS  Google Scholar 

  • Griggs RC, Nutt JG (1995) Episodic ataxias as channelopathies. Ann Neurol 37:285–287

    Article  PubMed  CAS  Google Scholar 

  • Ishiyama A, Jacobson KM, Baloh RW (2000) Migraine and benign positional vertigo. Ann Otol Rhinol Laryngol 109:377–380

    PubMed  CAS  Google Scholar 

  • Neuhauser H, Leopold M, von Brevem M, Arnold G, Lempert T (2001) The interrelations of migraine, vertigo and migrainous vertigo. Neurology 56:436–441

    Article  PubMed  CAS  Google Scholar 

  • Ophoff RA, Terwindt GM, Vergouwe MN, van Eijk R, Oefner PJ, Hoffman SM et al (1996) Familial hemiplegic migraine and episodic ataxia type-2 are caused by mutations in the Ca2+ channel gene CACNL1A4. Cell 87:543–552

    Article  PubMed  CAS  Google Scholar 

  • Radtke A, Lempert T, Gresty MA, Brookes GB, Bronstein AM, Neuhauser H (2002) Migraine and Meniere’s disease. Is there a link? Neurology 59:1700–1704

    Article  PubMed  CAS  Google Scholar 

  • Rassekh CH, Harker LA (1992) The prevalence of migraine in Meniere’s disease. Laryngoscope 102:135–138

    Article  PubMed  CAS  Google Scholar 

  • Weiller C, May A, Limmroth V, Jiipter M, Kaube H, van Schayck R, Coenen HH, Diener HC (1995) Brain stem activation in spontaneous human migraine attacks. Nat Med 1:658–660

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neurologische Klinik und Poliklinik, Universitätsklinikum Großhadern, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, München, Deutschland

    Prof. Dr. med. Dr. h.c. Thomas Brandt FRCP & Prof. Dr. med. Michael Strupp

  2. Neurologische Universitätsklinik, Klinikum der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland

    Prof. Dr. med. Marianne Dieterich

Authors
  1. Prof. Dr. med. Dr. h.c. Thomas Brandt FRCP
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Prof. Dr. med. Michael Strupp
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Prof. Dr. med. Marianne Dieterich
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Brandt, T., Strupp, M., Dieterich, M. (2004). Zentrale vestibuläre Schwindelformen. In: Vertigo. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-662-13375-0_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-13375-0_3

  • Publisher Name: Steinkopff, Heidelberg

  • Print ISBN: 978-3-662-13376-7

  • Online ISBN: 978-3-662-13375-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation