Research in Vestibular Science

Case Report

Posterior Inferior Cerebellar Artery Stenosis Presenting as Recurrent Orthostatic Dizziness: Seongjin Jeon, Ji-Yun Park, Jong-min Lee, Seulgi Hong; Res Vestib Sci. 2022;21(2):53-56. Published online June 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.2.53

Abstract PDF: We report a unique case of vertebrobasilar transient ischemic attacks manifesting as isolated, recurrent, orthostatic dizziness with posterior inferior cerebellar artery (PICA) stenosis. A 57-year-old male patient without past medical history, presented with brief orthostatic dizziness for 2 weeks. There was no associated nausea, vomiting, diplopia, or weakness. On neuro-otologic examination, the patient did not show spontaneous, positional, or gaze-evoked nystagmus. Vestibular function tests such as caloric test, head impulse test, video-oculography, and tilt table test were normal. Brain diffusion-weighted images showed multiple small high signal intensities in the bilateral cerebellar hemispheres. Brain magnetic resonance angiography revealed hypoplasia of the right vertebral artery without focal intracranial focal stenosis. Four-vessel cerebral angiogram showed severe stenosis at the right PICA artery. Our patient’s clinical scenario appears unique hemodynamic spells without symptoms or signs of posterior circulation ischemia. Physicians should also consider cerebrovascular ischemic when the patient suffers repeated orthostatic dizziness that is not explained clinically.

Review

Clinical Significance and Update of Postural Orthostatic Tachycardia Syndrome: Jung A Park, Jae Han Park; Res Vestib Sci. 2022;21(1):1-5. Published online March 15, 2022; DOI: https://doi.org/10.21790/rvs.2022.21.1.1

Abstract PDF: Postural orthostatic tachycardia syndrome (POTS) is a cerebrovascular autonomic dysfunction that is common in young women. POTS can cause dizziness due to orthostatic intolerance. In patients with orthostatic intolerance, it can be diagnosed when the heart rate increases by more than 30 beats per minute within 10 minutes of standing up through the head-up tilt test. However, even a neuro-otologist has difficulty in diagnosing POTS due to the high possibility of misdiagnosis if not paying attention. In this paper, the clinical symptoms, pathophysiology, diagnosis, and treatment of POTS are investigated. In addition, the latest knowledge of POTS is searched to help diagnose and treat POTS.

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