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Acute rotatory vertigo caused by a small haemorrhage of the vestibular cortex
  1. J Boiten1,
  2. J Wilmink2,
  3. H Kingma3
  1. 1Department of Neurology, St Anna Hospital, PO Box 90, NL-5660 AB Geldrop, Netherlands
  2. 2Department of Radiology, University Hospital Maastricht, Maastricht, Netherlands
  3. 3Department of ORL and Head and Neck Surgery, University Hospital Maastricht
  1. Correspondence to: Dr Jelis Boiten;
 jelis.boiten{at}st-anna.nl

https://doi.org/10.1136/jnnp.74.3.388

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    Central rotatory vertigo is in most cases caused by a lesion of the cerebellum or brain stem. We describe a patient with acute rotatory vertigo following a small haemorrhage in the left medial temporal gyrus, which probably injured the vestibular cortex.

    Case history

    A 53 year old woman suddenly experienced leftwards directed rotatory vertigo in the yaw plane and nausea without vomiting. She felt unsteady and had short lasting slurring of her speech. She had no hearing loss or tinnitus. On examination, she could stand unaided but tended to fall after a short while, without a directional preponderance. Gait was severely unsteady and she could not walk unaided. The rotatory vertigo was worse when she was sitting upright than when lying down in bed. Vertigo was also increased by head movements.

    Examination of the cranial nerves showed no abnormalities; specifically there was no nystagmus or hearing loss and the eye movements were normal. Neurological examination of the limbs (motor and sensory function, coordination, and reflexes) was normal. Electroencephalography showed no abnormalities, supporting a non-epileptic cause of the vertigo. …

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    Footnotes

    • Competing interests: none declared