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Cerebellar infarction presenting with isolated positional vertigo: differentiating factors for benign paroxysmal positional vertigo

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Abstract

Background

Isolated central positional vertigo (CPV) due to cerebellar infarction is often difficult to differentiate from benign paroxysmal positional vertigo (BPPV). Here, we aimed to evaluate whether vascular risk factors and serum vitamin D level can differentiate between positional vertigo types.

Methods

A total of 78 consecutive patients were consecutively enrolled from January 2017. All CPV patients had a National Institutes of Health Stroke Scale score of 0 and cerebellar infarctions confirmed by brain MR imaging. Vascular risk factors and serum 25-hydroxyvitamin D levels were compared between the two groups of patients.

Results

The proportion of men was higher in the CPV than in the BPPV group (p = 0.004). Atrial fibrillation was common in the CPV group on univariate analysis (p = 0.046). However, there were no independent differentiating factors between the two groups. The proportion of patients according to the number of risk factors was significantly different between the two groups (linear by linear association test, p = 0.02). The mean serum 25-hydroxyvitamin D level did not differ. Also, the proportions of vitamin D insufficiency and deficiency did not differ significantly between the two groups.

Conclusions

Increased number of vascular risk factors including male sex suggested more CPV than BPPV. However, the serum vitamin D level was below the normal range in both groups. Our results demonstrate that serum vitamin D level has little value in the differential diagnosis of positional vertigo. Efforts to identify differentiating factors are warranted, and accumulating evidences including our research may lead to a diagnostic algorithm for isolated positional vertigo.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Neurology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, South Korea

    Jae-Myung Kim, Seung-Han Lee, Soo Hyun Cho, Kyung Wook Kang, Kang-Ho Choi, Tai-Seung Nam, Joon-Tae Kim, Seong-Min Choi, Man-Seok Park, Byeong C. Kim & Myeong-Kyu Kim

  2. Chonnam National University Medical School, Gwangju, South Korea

    Jae-Myung Kim, Seung-Han Lee, Soo Hyun Cho, Kyung Wook Kang, Kang-Ho Choi, Tai-Seung Nam, Joon-Tae Kim, Seong-Min Choi, Man-Seok Park, Byeong C. Kim & Myeong-Kyu Kim

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  1. Jae-Myung Kim
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Contributions

JM Kim conceived of the study, analyzed the data, reviewed the literatures, and drafted the manuscript and approved the final version of the manuscript. SH Lee conceived of the study, interpreted the data, critically reviewed, and edited the manuscript and approved the final version of the manuscript. SH Cho, KW Kang, KH Choi, and TS Nam collected and analyzed the data, critically reviewed and edited the manuscript, and approved the final version of the manuscript. JT Kim, SM Choi, MS Park, BC Kim, and MK Kim interpreted neuroimaging data, critically reviewed and edited the manuscript and approved the final version of the manuscript.

Corresponding author

Correspondence to Seung-Han Lee.

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This study was performed in accordance with the recommendations of the Institutional Review Board of the Chonnam National University Hospital (Gwangju, South Korea).

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Kim, JM., Lee, SH., Cho, S.H. et al. Cerebellar infarction presenting with isolated positional vertigo: differentiating factors for benign paroxysmal positional vertigo. Neurol Sci 42, 1045–1052 (2021). https://doi.org/10.1007/s10072-020-04617-w

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