Central Lesions With Selective Semicircular Canal Involvement Mimicking Bilateral Vestibulopathy
| Autor: | G. Michael Halmagyi, Luke Chen |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Pathology medicine.medical_specialty semicircular canal Mini Review lcsh:RC346-429 03 medical and health sciences 0302 clinical medicine central vestibular disorders medicine.artery medicine bilateral vestibulopathy lcsh:Neurology. Diseases of the nervous system Vestibular system Vestibular areflexia Wernicke Encephalopathy Semicircular canal business.industry Head impulse test medicine.disease Medial longitudinal fasciculus Bilateral vestibulopathy Anterior inferior cerebellar artery stomatognathic diseases eye movements 030104 developmental biology medicine.anatomical_structure Neurology Neurology (clinical) business head impulse test 030217 neurology & neurosurgery Neuroscience |
| Zdroj: | Frontiers in Neurology Frontiers in Neurology, Vol 9 (2018) |
| ISSN: | 1664-2295 |
| Popis: | Bilateral vestibulopathy (BVP), which is due to peripheral lesions, may selectively involve certain semicircular canal (SCC). Recent eye movement recordings with search coil and video head impulse test (HIT) have provided insight in central lesions that can cause bilateral and selective SCC deficit mimicking BVP. Since neurological signs or ocular motor deficits maybe subtle or absent, it is critical to recognize central lesions correctly since there is prognostic and treatment implication. Acute floccular lesions cause bilateral horizontal SCC (HC) impairment while leaving vertical SCC function unaffected. Vestibular nuclear lesions affect bilateral HC and posterior SCC (PC) function, but anterior SCC (AC) function is spared. When both eyes are recorded, medial longitudinal fasciculus lesions cause horizontal dysconjugacy in HC function and catch-up saccades, as well as selective deficiency of PC over AC function. Combined peripheral and central lesions may be difficult to distinguish from BVP. Anterior inferior cerebellar artery stroke causes two types of deficits: 1. ipsilateral pan-SCC deficits and contralateral HC deficit and 2. bilateral HC deficit with vertical SCC sparing. Metabolic disorders such as Wernicke encephalopathy characteristically involve HC but not AC or PC function. Gaucher disease causes uniform loss of all SCC function but with minimal horizontal catch-up saccades. Genetic cerebellar ataxias and cerebellar-ataxia neuropathy vestibular areflexia syndrome typically do not spare AC function. While video HIT does not replace the gold-standard, search coil HIT, clinicians are now able to rapidly and accurately identify specific pattern of SCC deficits, which can aid differentiation of central lesions from BVP. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|