When examining patients with vertigo, it is essential to differentiate between central and peripheral causes. We report on a patient who had been treated as a case of benign paroxysmal positional vertigo (BPPV), but was eventually diagnosed as having cerebellar nodulus infarction. The patient visited our hospital complaining of rotatory vertigo, and we diagnosed and treated the patient as a case of BPPV. He was able to walk, but the dizziness changed from rotatory vertigo persisted. Computed tomography angiography (CTA) revealed obstruction of the right vertebral artery, and the patient was eventually diagnosed as having cerebellar nodulus infarction. Infarction in the lower cerebellum is characterized by vertigo without cerebellar ataxia, and the clinical picture may resemble that of vestibular neuritis or BPPV. We should be aware of cases of cerebellar infarction in which nystagmus can mimic that in BPPV.
