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Nodulus infarction mimicking acute peripheral vestibulopathy

From the Department of Neurology (Drs. Lee, Yi, and Cho), Brain Research Institute (Drs. Lee, Cho, and Sohn), Department of Radiology (Dr. Sohn), Keimyung University School of Medicine, Daegu, South Korea; Department of Neurology (Dr. Whitman), University of California, Irvine College of Medicine, Irvine, CA; and the Departments of Neurology (Drs. Ying and Baloh) and Surgery, Division of Head and Neck Surgery (Dr. Baloh), UCLA School of Medicine, Los Angeles, CA.

Address correspondence and reprint requests to Dr. Gregory T. Whitman, Department of Neurology, University of California–Irvine Medical Center, Building 53, Room 203, 101 The City Drive South, Orange, CA 92868; e-mail: gwhitman{at}uci.edu

The authors report two patients with cerebellar infarctions in the territory of the medial branch of the posterior inferior cerebellar artery who had vertigo, spontaneous ipsilesional nystagmus, and contralesional truncal lateropulsion. Although one of the two patients had slight dysmetria, overall signs closely mimicked those of acute peripheral vestibulopathy. The authors suggest that interruption of nodulouvular inhibitory projections to vestibular nuclei may account for the vestibular signs.

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