Research in Vestibular Science

Arnold-Chiari Type 1 Malformation Mimicking Benign Paroxysmal Positional Vertigo: Young Chul Kim, Chae Dong Yim, Hyun Jin Lee, Dong Gu Hur, Seong Ki Ahn; Res Vestib Sci. 2019;18(3):87-90. Published online September 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.3.87

Abstract PDF: Arnold-Chiari malformation type 1 is a congenital disease characterized by herniation of the cerebellar tonsils through the foramen magnum. Most common clinical symptom is pain, including occipital headache and neck pain, upper limb pain exacerbated by physical activity or valsalva maneuvers. Various otoneurological manifestations also occur in patients with the disease, which has usually associated with dizziness, vomiting, dysphagia, poor hand coordination, unsteady gait, numbness. Patients with Arnold-Chiari malformation may develop vertigo after spending some time with their head inclined on their trunk. Positional and down-beating nystagmus are common forms of nystagmus in them. We experienced a 12-year-old female who presented complaining of vertigo related to changes in head position which was initially misdiagnosed as a benign paroxysmal positional vertigo.

Injury Mechanism to Induce Traumatic Balance Disorder: Jeong Wook Kang, Jae-Yong Byun; Res Vestib Sci. 2019;18(1):1-7. Published online March 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.1.1

Abstract PDF: Many of the dizziness patients annually visit ENT (ear, nose, throat) clinics because the vestibular function is the major organ to keep body balance and belongs to the Otorhinolaryngology. Nevertheless, many otolaryngologists feel that it is not easy to access the dizziness patients. The reason is that dizziness is not a final diagnosis and it is necessary to start the diagnosis of dizziness and find out the cause. Also, the causes of dizziness belong to multiple medical departments. That is why we need to pay more attention. Among them, traumatic vertigo can be manifested in various ways depending on the injury site and mechanism, and it is often difficult to predict the medical prognosis. Therefore, this review article focuses on traumatic vertigo. In this paper, we discussed its epidemiology and mechanism to help clinicians to treat patients with traumatic vertigo.

Gaze-Evoked and Perverted Head-Shaking Nystagmus in a Patient with Polycythemia Vera: Yong Soo Kim, Ik-Chan Song, Seong-Hae Jeong, Ae Young Lee, Jae Moon Kim; Res Vestib Sci. 2017;16(4):142-146. Published online December 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.4.142

Abstract PDF: Polycythemia vera (PV) is well known chronic myeloproliferative neoplasm, caused by clonal expansion of an abnormal hematopoietic stem cell. Patients with PV may present diverse neurologic symptoms including headache, dizziness or vertigo, tinnitus. However, the attention has not been directed to the neurootological findings in patients with PV. Here, we present a 71-year-old male patient with PV suffered from vertigo and headache. He demonstrated gaze-evoked nystagmus and perverted head shaking nystagmus. Transcranial Doppler showed decrement of blood flow velocity in posterior circulation. The patient’s neuro-otologic findings were normalized as polychethemia and blood flow improved with repetitive phlebotomy and medications such as hydroxyurea and aspirin. Considering the neurological and hemodynamic findings in our patient, the mechanism of vertigo in PV could be explained by central vestibulopathy because of vascular insufficiency rather than peripheral vestibulopathy because of inner ear blood hyperviscosity.

Bacterial Meningitis Initially Presenting as Labyrinthitis: Bon Min Koo, Sung Il Nam, Soon Hyung Park; Res Vestib Sci. 2017;16(2):69-72. Published online June 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.2.69

Abstract PDF: Labyrinthitis causes damage to inner ear structure, and in turn hearing loss and vertigo. Labyrinthitis is classified as otogenic labyrinthitis and meningogenic labyrinthitis. Otogenic labyrinthitis can be diagnosed early through otoscopic examination. However, when there are no characteristic neurologic symptoms in patients with meningogenic labyrinthitis, clinicians can overlook the underlying meningitis and this may lead to the peripheral vertigo. We encountered an unusual case of meningogenic labyrinthitis that is misdiagnosed as peripheral dizziness.

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