For differential diagnosis between vestibular neuritis and lateral medullary infarction with similar clinical features, bedside examination of nystagmus is important. We report a 45-year-old male who presented with acute vertigo for two days. He showed spontaneous right-beating nystagmus. However, left-beating nystagmus was evoked during bilateral horizontal gaze and by horizontal head oscillation. Brain MRI revealed an acute infarction in the left lateral medulla.
Brain ; Diagnosis, Differential ; Head ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Vertigo ; Vestibular Neuronitis