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Unilateral Parieto-Occipital Lobe Infarction Presenting with Optic Ataxia and Saccadic Abnormalties: A Case Report .

Journal of the Korean Balance Society.2006;5(2):320-324.

Optic ataxia is characterized by an impaired visual control of the direction of arm reaching to a visual target, accompanied by defective hand orientation and grip formation. In humans, optic ataxia is associated with lesions of the superior parietal lobule, which also affect visually guided saccades and other forms of eye-hand coordination. A 67-year-old woman presented with sudden, unilateral, direct optic ataxia in the right homonymous half field and saccadic abnormalities which consisted of prolonged latency, undershoot dysmetria, and decreased velocity. Brain MRI showed a left parieto-occipital watershed infarction. It is suggested that lesions of the superior parietal lobule and the adjacent parietal eye field are responsible for optic ataxia and saccadic abnormalities, respectively.
Aged ; Arm ; Ataxia* ; Brain ; Cerebellar Ataxia ; Female ; Hand ; Hand Strength ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Rabeprazole ; Saccades

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Biphasic Head-Shaking Nystagmus in a Patient with Anterior Inferior Cerebellar Artery Infarction.

Won Hee CHUNG ; Jeong Ho PARK ; Tae Kyeong LEE ; Ki Bum SUNG

Journal of the Korean Balance Society.2006;5(2):317-319.

Head-shaking test is a sensitive screening tool for a detection of peripheral and central vestibular system disease. Biphasic head-shaking nystagmus (b-HSN) is a rather uncommon phenomenon which was a combination of the paretic nystagmus and recovery nystagmus. We report characteristics of b-HSN in a patient with anterior inferior cerebellar artery infarction, whose only complaint was recurrent vertigo.
Arteries* ; Humans ; Infarction* ; Mass Screening ; Vertigo

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A Case of Herpes Zoster Oticus Involving Vestibular Nerve without Facial Nerve Palsy .

Sung Hyun BOO ; Kwon Hyo BOK ; Nam Gyu RYU ; Won Ho CHUNG

Journal of the Korean Balance Society.2006;5(2):311-316.

Herpes zoster oticus (Ramsay Hunt syndrome) is characterized by facial nerve paralysis associated with vesticular eruptions and cochleovestibular symptoms. Many evidences have supported that it is caused by the reactivation of latent varicella-zoster virus in the geniculate ganglion. Recently we experienced a case 49-year-old man presented severe vertigo and a vesicular eruptions of auricle and external ear canal. It is an unusual variant of herpes zoster oticus that involves only vestibular nerve without facial nerve palsy and hearing loss. We believe this case results from reactivation of latent varicella zoster virus in the vestibular ganglion and report with a review of literatures.
Dizziness ; Ear Canal ; Facial Nerve* ; Ganglion Cysts ; Geniculate Ganglion ; Hearing Loss ; Herpes Zoster Oticus* ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Middle Aged ; Paralysis* ; Vertigo ; Vestibular Nerve*

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A Case of Carotid Cavernous Fistula Presenting with "Delayed Red-Eyed Shunts".

Ki Bum SUNG ; Won Hee CHUNG ; Jeong Ho PARK ; Dae Ho KIM

Journal of the Korean Balance Society.2006;5(2):307-310.

Presenting symptoms of carotid cavernous fistulas (CCF) may vary according to the draining vessels. Prominent external orbito-ocular signs such as red eye, proptosis, ocular bruit occur, when the shunt drains anteriorly ("red-eyed shunts"), whereas an isolated ocular motor nerve palsy and headache can be the only presenting symptoms when it drains posteriorly ("white-eyed shunts"). Turning the eyes red from white eyed-shunt weeks to months ("delayed red-eyed shunts") suggest the direction of fistula drainage shifted anteriorly; it has rarely been reported. We report a patient with delayed red-eyed shunts whose red eye resolved after chemical embolization of draining vessels.
Carotid-Cavernous Sinus Fistula ; Drainage ; Exophthalmos ; Fistula* ; Headache ; Humans ; Paralysis

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Bilateral Inversion of Initial Nystagmus in Benign Paroxysmal Positional Vertigo of Horizontal Canal.

Myung Whan SUH ; Sang Wook KIM ; Min Hyun PARK ; Ji Soo KIM ; Ja Won KOO

Journal of the Korean Balance Society.2006;5(2):299-306.

Horizontal canal benign paroxysmal positional vertigo (HC-BPPV) is characterized by direction-changing nystagmus of the horizontal component induced by lateral head turning in supine position. Yet, some patients with HC-BPPV show nystagmus inversion during head turning to one side. And, mostly, the nystagmus started in a geotropic direction and the inversion was observed only when the head is turned to the lesion side. Reversal of the clot movement in the canal and sensory adaptation were suggested as the hypothesis for such finding. However, bilateral inversion of geotropic nystagmus into apogeotropic nystagmus in HC-BPPV has seldom been described before. In this paper, the authors presented the characteristic features and progression during reposition of a patient with bilateral nystagmus inversion and speculated its mechanisms.
Diagnosis ; Head ; Humans ; Semicircular Canals ; Supine Position ; Vertigo*

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Specific MRI and MRA findings of Dural Carotid Cavernous Sinus Fistula:A Case Report.

Won Hee CHUNG ; Jong Se LEE ; Tae Kyeong LEE ; Ki Bum SUNG

Journal of the Korean Balance Society.2006;5(2):296-298.

Dural carotid-cavernous sinus fistula (d-CCF) is a rare cause of ophthalmoplegia, and it may be overlooked when the prominent external orbito-ocular sign is lacking. Conventional angiography is the gold standard in the diagnosis of d-CCF. Recently, the specific MR findings of d-CCF have increasingly been reported. We report a patient with spontaneous d-CCF presenting with an isolated fourth-nerve palsy in whom magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) demonstrated d-CCF.
Angiography ; Carotid-Cavernous Sinus Fistula ; Cavernous Sinus* ; Diagnosis ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging* ; Ophthalmoplegia ; Paralysis

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Partial Oculomotor Nerve Palsy due to Different Fascicular Involvements in Recurrent Midbrain Infarctions.

Jeong Ho PARK ; Won Hee CHUNG ; Tae Kyeong LEE ; Ki Bum SUNG

Journal of the Korean Balance Society.2006;5(2):292-295.

We experienced a patient with partial oculomotor palsy who had initially manifested pupillary mydriasis and inferior rectus palsy which were attributed to an ipsilateral fascicular lesion in midbrain. She developed ipsilateral ptosis and monocular elevation palsy due to a new lesion on MRI one month later. This case could be the first neuroimaging evidence which support the hypothesis that fascicles of the oculomotor nerve for inferior oblique, superior rectus, and levator palphebrae muscle fibers are located more laterally and caudally than fascicles for pupil and inferior rectus muscle within midbrain tegmentum.
Humans ; Infarction* ; Magnetic Resonance Imaging ; Mesencephalon* ; Mydriasis ; Neuroimaging ; Oculomotor Nerve Diseases* ; Oculomotor Nerve* ; Paralysis ; Pupil

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Unilateral Peripheral Vestibulopathy associated with Cerebral Venous Infarction .

Hyun Ah KIM ; Hyung LEE ; Byung Rim PARK

Journal of the Korean Balance Society.2006;5(2):285-287.

Cerebral venous infarction is associated with a wide variety of clinical symptoms and signs, which may often delay appropriate diagnosis. Unilateral vestibular deficit as a presenting sign of cerebral venous infarction has rarely been reported. We report a patient with cerebral venous infarction who had severe prolonged vertigo, vomiting, occipital headache, positive head thrust testing, and unilateral caloric weakness as main clinical features. Although the patient had occipital headache, overall symptoms and signs closely mimicked those of acute peripheral vestibulopathy.
Diagnosis ; Head Impulse Test ; Headache ; Humans ; Infarction* ; Vertigo ; Vestibular Neuronitis ; Vomiting

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A Rostro-Caudal Arrangement of the Oculomotor Fascicles Based on MR Findings of Midbrain Infarctions in Two Cases .

Jeong Ho PARK ; Won Hee CHUNG ; Tae Kyeong LEE ; Ki Bum SUNG

Journal of the Korean Balance Society.2006;5(2):281-284.

A rostro-caudal topography of the oculomotor nerve fascicles is relatively well known in animal but not in human. We experienced two cases of midbrain infarctions presenting with isolated oculomotor nerve palsies. The MRI of the patient who had monocular elevation palsy with ptosis revealed a lesion in the middle to lower midbrain, whereas that of the other who had monocular depression and adduction palsy with pupillary mydriasis showed a discrete lesion in the upper to middle midbrain. We present the rostro-caudal arrangement of the oculomotor fascicles within midbrain based on MRI findings.
Animals ; Depression ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Mesencephalon* ; Mydriasis ; Oculomotor Nerve ; Oculomotor Nerve Diseases ; Paralysis

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Vestibular Neuritis of Vascular Cause .

Hyun Ah KIM ; Hyung LEE ; Byung Rim PARK

Journal of the Korean Balance Society.2006;5(2):277-280.

Vestibular neuritis (VN) is an idiopathic peripheral vestibular syndrome characterized by acute isolated prolonged vertigo. In most cases, it results from inflammation of the vestibular nerve presumably of viral origin. There has been no previous report of VN associated with a vascular cause. We here report a patient with VN of vascular origin who presented with acute onset of prolonged isolated vertigo, a unilateral decreased caloric response, and simultaneously with acute infarcts on brain MRI that were unrelated to patient's vertigo.
Brain ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Vertigo ; Vestibular Nerve ; Vestibular Neuronitis*

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