1993 Volume 52 Issue 3 Pages 401-410
A 55-year-old female was admitted to hospital after the acute onset of vertigo similar to thet of Meniere's disease. She also complained of nausea, vomiting, left tinnitus, left hearing loss and diplopia. A right Horner's syndrome, pain and temperature loss over the right side of the face and left trunk and limbs were noted. However, she had no limb ataxia or dysarthria. Magnetic resonance imaging (MRI) demonstrated a right inferior cerebellar infarction. Ocular motor abnormalities were : skew deviation, mixed horizontal-torsional nystagmus toward the left, and upbeating vertical nystagmus. In addition, in the positional nystagmus with the right-side (damaged side) down, vertical nystagmus was directed upward, and with the left-sidedown, anticlockwise torsional nystagmus of large amplitude appeared accompanied by an intense sensation of vertigo. We attribute the nystagmus to an imbalance of central projections from the anterior and posterior semicircular canals and the otolith receptors that mediate ocular counter-roll.
