Aperiodic alternating nystagmus in isolated vestibular nucleus infarction

  • Chang-Hee Kim
  • Kwang-Dong ChoiEmail author
Letter to the Editors

Dear Sirs,

In patients with an acute vestibular syndrome, it is sometimes challenging to make a differential diagnosis between acute peripheral vestibulopathy (APV) and central vestibular disorders [1]. Isolated acute vertigo has been reported in a tiny infarct involving caudal cerebellum [2, 3, 4, 5] or vestibular nucleus (VN) [6, 7]. Patients with isolated VN infarction mostly presented with combined clinical features of peripheral and central vestibulopathy [6, 7]. However, aperiodic alternating nystagmus has not been described in isolated VN infarction. We report a patient with isolated VN infarction who initially presented with clinical manifestations of APV, and subsequently developed aperiodic alternating nystagmus.

A 57-year-old previously healthy woman developed acute spontaneous vertigo with nausea and vomiting. On examination, she showed right-beating spontaneous nystagmus (SN) with a torsional component, which was attenuated by visual fixation (Supplemental video 1). A...


Compliance with ethical standards

Conflicts of interest

We have no disclosure of any competing interest.

Ethical approval for research involving human participants and/or animals

All experiments followed the tenets of the Declaration of Helsinki, and this study was approved by the institutional review board.

Supplementary material

415_2019_9504_MOESM1_ESM.avi (327.5 mb)
Supplemental Video 1. The patient show right-beating spontaneous nystagmus about 15 hours after symptom onset (AVI 335404 kb)
415_2019_9504_MOESM2_ESM.avi (175.2 mb)
Supplemental Video 2. The patient show aperiodic alternating nystagmus about 40 hours after symptom onset (upper panel of Fig. 1b). (AVI 179396 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical ScienceKonkuk University School of MedicineSeoulRepublic of Korea
  2. 2.Department of Neurology, Pusan National University HospitalPusan National University School of Medicine and Biomedical Research InstituteBusanSouth Korea

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