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Neurology 2000;54:1376-1379
© 2000 American Academy of Neurology
Brief Communications

Rotational vertebral artery occlusion syndrome with vertigo due to "labyrinthine excitation"

M. Strupp, MD, J. H. Planck, MD, V. Arbusow, MD, H.-J. Steiger, MD, H. Brückmann, MD and T. Brandt, MD, FRCP

From the Departments of Neurology (Drs. Strupp, Planck, Arbusow, and Prof. Brandt), Neurosurgery (Prof. Steiger), and Neuroradiology (Prof. Brückmann), Klinikum Großhadern, Ludwig-Maximilians University, Munich, Germany.

Address correspondence and reprint requests to Priv.-Doz. Dr. M. Strupp, Department of Neurology, Ludwig-Maximilians University, Klinikum Großhadern, Marchioninistraße 15, D-81366 Munich, Germany.

Leftward head rotations in a patient with a rotational vertebral artery occlusion syndrome elicited recurrent uniform attacks of severe rotatory vertigo and tinnitus in the right ear. These attacks were accompanied by a mixed clockwise torsional downbeat nystagmus with a horizontal component toward the right. A transient ischemia of the right labyrinth probably induced the attacks and led to a combined transient excitation of the right anterior and horizontal semicircular canals as well as the cochlea.

Key words: Vertigo—Nystagmus—Head rotation—Vertebral artery compression.




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