2023 Volume 83 Issue 4 Pages 253-258
We present three cases diagnosed with central vertigo following referrals from other departments with suspected peripheral vertigo. The first case included a 33-year-old man who visited the emergency department due to severe vertigo, nausea, and neck pain the day before. The computed tomography （CT） scans revealed no abnormalities. The patient was referred to the otorhinolaryngology department on suspicion of benign paroxysmal positional vertigo （BPPV）. However, a vertical nystagmus was observed and the magnetic resonance imaging （MRI） scan of the head led to the diagnosis of Wallenberg syndrome. The second case included a 46-year-old woman who visited the gastroenterology department complaining of dizziness and hiccups following the treatment for acute gastroenteritis. The patient was referred to the otorhinolaryngology department on suspicion of Meniere’s disease, but vertical nystagmus and dysphagia were observed and the MRI scan of the head revealed brainstem inflammation, leading to the diagnosis of neuromyelitis optica at the neurology department. The third case included a 55-year-old woman undergoing chemotherapy for breast cancer who visited the breast oncology department owing to the onset of vertigo and headache during treatment. She was referred to the otorhinolaryngology department on suspicion of BPPV, but a CT scan of the head revealed breast cancer metastasis to the brain. The different imaging techniques were useful for the diagnosis in all three cases.
