2025 Volume 74 Issue 3 Pages 597-604
Equilibrium function testing is essential for determining the cause of dizziness, particularly in distinguishing between central and peripheral types of nystagmus. Central dizziness can be life-threatening, and there for early detection and treatment are essential. A 59-year-old man suddenly developed vertigo and visited the emergency department of our hospital. The patient presented with unsteadiness, hearing loss, ear fullness, and nystagmus when gazing up, down, left, or right; however, a computed tomography (CT) scan revealed no obvious intracranial lesions. Additionally, a magnetic resonance imaging (MRI) scan ruled out acute cerebral infraction, although a left vertebral artery infarction was noted. Therefore, sudden deafness was suspected, and the patient was monitored. On the fourth night after admission, he developed numbness in the left cheek, followed by left facial nerve paralysis on the next morning. A hearing test conducted on the fifth day of hospitalization indicated worsening hearing loss. Furthermore, the equilibrium function test revealed nystagmus, suggesting a central cause. A repeat MRI scan confirmed a cerebral infarction, leading to a diagnosis of anterior inferior cerebellar artery infarction. When hearing loss or dizziness is present, it is essential to conduct a comprehensive diagnosis based on subsequent cerebellar symptoms and findings from the equilibrium function test, as acute cerebral infarction may not be effectively diagnosed by imaging tests.
