A 53-year-old woman with cerebellar infaction who complained of dizziness as an isolated symptom was presented. She had a normal brain CT scan and no neurological abnormalities at the onset, and she was initially diagnosed as having peripheral vestibular disorder. However, her oculomotor findings obtained 1 week after the onset revealed an impaired pursuit eye movement, lower gain on optokinetic nystagmus, and a failure of visual suppression on a caloric nystagmus test. From the neurootological findings, we suspected that she had a cerebellar lesion and an MRI revealed increased signal intensity in the cerebellar hemisphere. Consequently, the patient was diagnosed as having cerebellar infarction.
Symptoms of cerebellar infarcts are frequently similar to those of peripheral vestibular disease, and such patients may be overlooked if neurootological tests are not performed. In particular, oculomotor tests in patients with vertigo/dizziness are very useful to differentiate central nervous system disorders from peripheral vestibular disorders.
