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Miscellaneous Central Vestibular Disorders

  • Thomas Brandt
Part of the Clinical Medicine and the Nervous System book series (CLIN.MED.NERV.)

Abstract

Small Cerebellar Infarctions. Such lesions in the territory of either the anterior inferior cerebellar artery (AICA) or the posterior inferior cerebellar artery (PICA) have been repeatedly reported to mimic unilateral peripheral labyrinthine disorder, mostly with a similarly benign course (Duncan et al. 1975; Guiang and Ellington 1977; Rubinstein et al. 1980; Samson et al. 1981; Kömpf 1986). The areas covered by these arteries and the anatomy of the collaterals are both variable, so it is sometimes difficult to decide which artery is responsible for clinical signs or infarcted areas seen on CT scans or MRI. When the PICA is hypoplastic, the AICA takes over the territory usually supplied by the lateral branch of the PICA (Amarenco and Hauw 1989). All reports are entitled “cerebellar infarctions causing vertigo”, which is correct on the basis of the imaging data and concurrent clinical signs, but it is more likely that the vertigo itself results from pontomedullary brainstem ischaemia near the vestibular nuclei. The AICA supplies the rostral part of the vestibular nuclei, the middle cerebellar peduncle, the flocculus and the neighbouring lobules of the cerebellum. The PICA supplies the caudal part of the vestibular nuclei and the dorsal medullary territory, the uvular and the nodulus (Amarenco and Hauw 1989). Occlusion of the PICA causes the typical Wallenberg’s syndrome.

Keywords

Vestibular Nucleus Posterior Inferior Cerebellar Artery Anterior Inferior Cerebellar Artery Middle Cerebellar Peduncle Vestibular Neuritis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Amarenco P, Hauw JJ (1989) Anatomie des artères cérébelleuses. Rev Neurol (Paris) 145:267–276Google Scholar
  2. Andermann F, Cosgrove JBR, Lloyd-Smith D, Walters AM (1959) Paroxysmal dysarthria and ataxia in multiple sclerosis. Neurology (Minneap) 9:211–215Google Scholar
  3. Brandt Th, Dieterich M (1987) Pathological eye-head coordination in roll: Tonic ocular tilt reaction in mesencephalic and medullary lesions. Brain 110:649–666PubMedCrossRefGoogle Scholar
  4. Brandt Th, Dieterich M, Büchele W (1986) Postural abnormalities in central vestibular brainstem lesions. In: Bles W, Brandt Th (eds) Disorders of posture and gait. Elsevier, Amsterdam, pp 141–156Google Scholar
  5. Büttner U, Straube A, Brandt Th (1987) Paroxysmal spontaneous nystagmus and vertigo evoked by lateral eye position. Neurology 37:1553–1555PubMedGoogle Scholar
  6. Gambier J, Elghozi D, Strube E (1980) Lésions du thalamus droit avec syndrome de Themisphère mineur. Discussion du concept de négligence thalamique. Rev Neurol (Paris) 136:105–116Google Scholar
  7. Duncan GW, Parker SW, Fisher CM (1975) Acute cerebellar infarction in the PICA territory. Arch Neurol 32:364–368PubMedCrossRefGoogle Scholar
  8. Espir MLE, Millac P (1970) Treatment of paroxysmal disorders in multiple sclerosis with carbamazepine (Tegretol). J Neurol Neurosurg Psychiat 33:528–531PubMedCrossRefGoogle Scholar
  9. Fariello RG, Schwartzman RJ, Beall SS (1983) Hyperekplexia exacerbated by occlusion of posterior thalamic arteries. Arch Neurol 40:244–246PubMedCrossRefGoogle Scholar
  10. Farmer TW, Mustian VM (1963) Vestibulocerebellar ataxia: A newly defined hereditary syndrome with periodic manifestations. Arch Neurol 8:471–480PubMedCrossRefGoogle Scholar
  11. Farris BK, Smith JL, Ayyar R (1986) Neuro-ophthalmologic (indings in vestibulocerebellar ataxia. Arch Neurol 43:1050–1053PubMedCrossRefGoogle Scholar
  12. Friedmann G (1970) The judgement of the visual vertical and horizontal with peripheral and central vestibular lesions. Brain 93:313–328PubMedCrossRefGoogle Scholar
  13. Guiang RL Jr, Ellington OB (1977) Acute pure vertiginous dysequilibrium in cerebellar infarction. Eur Neurol 16:11–15PubMedCrossRefGoogle Scholar
  14. Hassler R (1966) Thalamic regulation of muscle tone and the speed of movement. In: Purpura DP, Yahr MD (eds) The thalamus. Columbia University Press, New York, pp 419–438Google Scholar
  15. Hopf HC (1987) Vertigo and masseter paresis. A new local brainstem syndrome probably of vascular origin. J Neurol 235:42–45PubMedCrossRefGoogle Scholar
  16. Jenkyn LR, Alberti AR, Peters JD (1981) Language dysfunction, somesthetic hemi-inattention, and thalamic hemorrhage in the dominant hemisphere. Neurology 31:1202PubMedGoogle Scholar
  17. Kompf D (1986) Der benigne pseudovestibuläre Kleinhirninsult. Nervenarzt 57:163–166PubMedGoogle Scholar
  18. Mangabeira-Albernaz PL, Malavasi Gananca M (1988) Sudden vertigo of central origin. Acta Otolaryngol (Stockh) 105:564–569CrossRefGoogle Scholar
  19. Masdeu JC, Gorelick PB (1988) Thalamic astasia: Inability to stand after unilateral thalamic lesions. Ann Neurol 23:596–603PubMedCrossRefGoogle Scholar
  20. Meissner I, Wiebers DO, Swanson JW, O’Tallon WM (1986) The natural history of drop attacks. Neurology 36:1029–1034PubMedGoogle Scholar
  21. Merifield DO (1965) Self-limited idiopathic vertigo (epidemic vertigo). Arch Otolaryngol 81:355–358PubMedCrossRefGoogle Scholar
  22. Osterman PO, Westerberg CE (1975) Paroxysmal attacks in multiple sclerosis. Brain 98:189–202CrossRefGoogle Scholar
  23. Pedersen E (1959) Epidemic vertigo. Clinical picture, epidemiology and relation to encephalitis. Brain 82:566–580PubMedCrossRefGoogle Scholar
  24. Rubinstein RL, Norman DM, Schindler RA, Kaseff L (1980) Cerebellar infarction. A presentation of vertigo. Laryngoscope 90:505–514CrossRefGoogle Scholar
  25. Samson M, Mithout D, Thiebot J, Segond D, Weber J, Proust B (1981) Forme benigne des infarctus cérébelleux. Rev Neurol 137:373–382PubMedGoogle Scholar
  26. Sheldon JH (1948) The social medicine of old age: report of an enquiry in Wolverhampton. Oxford University Press, LondonGoogle Scholar
  27. Sheldon JH (1960) On the natural history of falls in old age. Br Med J (Clin Res) 2:1685–1690CrossRefGoogle Scholar
  28. Sogg RL, Hoyt WF (1962) Intermittent vertical nystagmus in a father and son. Arch Ophthalmol 68: 515–517PubMedCrossRefGoogle Scholar
  29. Svpert GW, Alvord EC (1975) Cerebellar infarction. A clinicopatholotiic study. Arch Neurol 32:357–363CrossRefGoogle Scholar
  30. Thurston STE, Leigh RJ, Osoria I (1985) Epileptic gaze deviation and nystagmus. Neurology 35: 1518–1521PubMedGoogle Scholar
  31. Velasco F, Velasco M (1979) A reticulothalamic system mediating proprioceptive attention and tremor in man. Neurosurg 4:30–36CrossRefGoogle Scholar
  32. Verma AK, Maheshwari MC (1986) Hyperesthetic-ataxic-hemiparesis in thalamic hemorrhage. Stroke 17:49–51PubMedCrossRefGoogle Scholar
  33. Zoll JG (1969) Transient anosognosia associated with thalamotomy; is it caused by proprioceptive loss? Confin Neurol 31:48–55PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 1991

Authors and Affiliations

  • Thomas Brandt
    • 1
  1. 1.Klinikum GrosshadernLudwig-Maximilians-Universität MünchenMünchen 70Germany

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