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Isolated acute vertigo in the elderly; vestibular or vascular disease?
Author(s) -
Norrving B.,
Magnusson M.,
Holtås S.
Publication year - 1995
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1995.tb05841.x
Subject(s) - vertigo , medicine , nystagmus , infarction , vestibular system , abnormality , radiology , magnetic resonance imaging , posterior inferior cerebellar artery , ataxia , vertebral artery , cardiology , myocardial infarction , surgery , psychiatry
Intruduction – ‐ Elderly patients with isolated acute vertigo are commonly encountered in clinical practice, but little is known about the underlying cause of the symptoms. Material & methods – ‐ We prospectively studied 24 patients aged 50–75 years with the acute onset of isolated vertigo lasting > 48 h and no abnormality on neurological examination other than nystagmus. The study protocol included neuro‐imaging (MRI 22 patients, CT 2 patients), Doppler sonography, and electro‐oculography. Results — MRI/CT showed the presence of an infarction of the caudal cerebellum in six patients (25%), 3 of whom had a potential cardioembolic source and normal Doppler sonography findings, whereas 3 patients had ipsilateral vertebral artery occlusion and normal cardiac findings. MRI of the posterior fossa was normal in 18 patients. On electro‐oculography, ataxic pursuit eye movements was a characteristic finding in patients with cerebellar infarction, whereas caloric test findings were not discriminative. Conclusion – ‐ A caudal cerebellar infarction may easily be misdiagnosed clinically as a labyrinthine disorder, and was found to be the cause in one fourth of patients presenting with isolated acute vertigo.