Abstract
A case of the localized infarction to the cerebellar vermis were studied neuro-otologically. The patient was a 22 years old male whose chief complaint was paroxysmal positional vertigo, accompaning with occipital headache, nausea and vomiting in the left lateral position (left ear downward). Neurological examination was within normal limits, while neuro-otological examination revealed several important findings suggesting the clinical diagnosis of cerebellar injury.
Characteristics of neuro-otological findings were: lateral gaze nystagmus, down beat vertical spontaneous nystagmus when eyes closed, hyperactive caloric response, downbeat vertical positioning nystagmus of small amplitude and high frequency with vertiginous sensation. On the other hand, the eye tracking test and the optokinetic nystagmus test showed almost normal pattern.
In this case of vascular disorder of cerebellar vermis, the Bruns syndrome (malignant paroxysmal positional vertigo) was considered to be as important as the archicerebellar syndrome.
