Central Conditions Mimicking Benign Paroxysmal Positional Vertigo: A Case Series.
Identifieur interne : 000055 ( Main/Exploration ); précédent : 000054; suivant : 000056Central Conditions Mimicking Benign Paroxysmal Positional Vertigo: A Case Series.
Auteurs : Laura Power [Australie] ; Kate Murray ; Kristian Bullus ; Katherine J. Drummond ; Nicholas Trost ; David J. SzmulewiczSource :
- Journal of neurologic physical therapy : JNPT [ 1557-0584 ] ; 2019.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Canaux semicirculaires osseux (MeSH), Diagnostic différentiel (MeSH), Femelle (MeSH), Humains (MeSH), Hydrocéphalie (complications), Hydrocéphalie (diagnostic), Mâle (MeSH), Nystagmus pathologique (diagnostic), Nystagmus pathologique (étiologie), Tumeurs du cervelet (complications), Tumeurs du cervelet (diagnostic), Vertige positionnel paroxystique bénin (complications), Vertige positionnel paroxystique bénin (diagnostic).
- MESH :
- diagnostic : Hydrocéphalie, Nystagmus pathologique, Tumeurs du cervelet, Vertige positionnel paroxystique bénin.
- étiologie : Nystagmus pathologique.
- complications : Adulte, Adulte d'âge moyen, Canaux semicirculaires osseux, Diagnostic différentiel, Femelle, Humains, Hydrocéphalie, Mâle, Tumeurs du cervelet, Vertige positionnel paroxystique bénin.
English descriptors
- KwdEn :
- Adult (MeSH), Benign Paroxysmal Positional Vertigo (complications), Benign Paroxysmal Positional Vertigo (diagnosis), Cerebellar Neoplasms (complications), Cerebellar Neoplasms (diagnosis), Diagnosis, Differential (MeSH), Female (MeSH), Humans (MeSH), Hydrocephalus (complications), Hydrocephalus (diagnosis), Male (MeSH), Middle Aged (MeSH), Nystagmus, Pathologic (diagnosis), Nystagmus, Pathologic (etiology), Semicircular Canals (MeSH).
- MESH :
- complications : Benign Paroxysmal Positional Vertigo, Cerebellar Neoplasms, Hydrocephalus.
- diagnosis : Benign Paroxysmal Positional Vertigo, Cerebellar Neoplasms, Hydrocephalus, Nystagmus, Pathologic.
- etiology : Nystagmus, Pathologic.
- Adult, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Semicircular Canals.
Abstract
BACKGROUND AND PURPOSE
Benign paroxysmal positional vertigo (BPPV) is the most common cause of positional vertigo. The term "benign" is consistent with a peripheral vestibular disorder that does not carry the potentially sinister sequelae of a central nervous system (CNS) cause. However, in 12% to 20% of cases, positional vertigo may be attributed to CNS pathology, including tumors of the cerebellum.
CASE DESCRIPTION
Here, we present a series of 3 cases in which positional vertigo and nystagmus were the only presenting features in 2 cases of cerebellar tumor and 1 case of obstructive hydrocephalus.
INTERVENTION
All patients underwent surgical intervention for removal of posterior fossa tumors or posterior fossa decompression for obstructive hydrocephalus. Following surgery, all 3 patients underwent a period of vestibular rehabilitation for postoperative motion sensitivity and balance impairment.
OUTCOMES
Despite the continuing presence of central positioning nystagmus, all 3 patients recovered well, putatively with the aid of vestibular rehabilitation.
DISCUSSION
The presence of central positioning nystagmus may be the sole presenting feature of serious neurological conditions such as posterior fossa tumor. It is recommended that a diagnosis of BPPV can only be made if Dix-Hallpike or supine roll maneuver elicits nystagmus that is consistent with BPPV. Any features of the nystagmus, which are not consistent with BPPV, should raise suspicion of central pathology, and warrant further investigation.Video Abstract available for more insights from the authors (see Video Abstract, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A265).
DOI: 10.1097/NPT.0000000000000276
PubMed: 31136448
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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<author><name sortKey="Power, Laura" sort="Power, Laura" uniqKey="Power L" first="Laura" last="Power">Laura Power</name>
<affiliation wicri:level="4"><nlm:affiliation>Balance Disorders and Ataxia Service, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia (L.P., D.J.S.); Florey Institute of Neuroscience and Mental Health, Melbourne, Australia (L.P., D.J.S.); Dizzy Day Clinics, Melbourne, Australia (L.P., K.M.); Department of Neurosurgery (K.B.) and Medical Imaging Department (N.T.), St Vincents Hospital, Melbourne, Australia; Department of Neurosurgery, Royal Melbourne Hospital, and Department of Surgery, University of Melbourne, Australia (K.J.D.); and Neuroscience Department, Cerebellar Ataxia Clinic, Alfred Health, Melbourne, Australia (D.J.S.).</nlm:affiliation>
<orgName type="university">Université de Melbourne</orgName>
<country>Australie</country>
<placeName><settlement type="city">Melbourne</settlement>
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<author><name sortKey="Murray, Kate" sort="Murray, Kate" uniqKey="Murray K" first="Kate" last="Murray">Kate Murray</name>
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<author><name sortKey="Bullus, Kristian" sort="Bullus, Kristian" uniqKey="Bullus K" first="Kristian" last="Bullus">Kristian Bullus</name>
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<author><name sortKey="Drummond, Katherine J" sort="Drummond, Katherine J" uniqKey="Drummond K" first="Katherine J" last="Drummond">Katherine J. Drummond</name>
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<author><name sortKey="Trost, Nicholas" sort="Trost, Nicholas" uniqKey="Trost N" first="Nicholas" last="Trost">Nicholas Trost</name>
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<author><name sortKey="Szmulewicz, David J" sort="Szmulewicz, David J" uniqKey="Szmulewicz D" first="David J" last="Szmulewicz">David J. Szmulewicz</name>
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<affiliation wicri:level="4"><nlm:affiliation>Balance Disorders and Ataxia Service, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia (L.P., D.J.S.); Florey Institute of Neuroscience and Mental Health, Melbourne, Australia (L.P., D.J.S.); Dizzy Day Clinics, Melbourne, Australia (L.P., K.M.); Department of Neurosurgery (K.B.) and Medical Imaging Department (N.T.), St Vincents Hospital, Melbourne, Australia; Department of Neurosurgery, Royal Melbourne Hospital, and Department of Surgery, University of Melbourne, Australia (K.J.D.); and Neuroscience Department, Cerebellar Ataxia Clinic, Alfred Health, Melbourne, Australia (D.J.S.).</nlm:affiliation>
<orgName type="university">Université de Melbourne</orgName>
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<author><name sortKey="Murray, Kate" sort="Murray, Kate" uniqKey="Murray K" first="Kate" last="Murray">Kate Murray</name>
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<author><name sortKey="Bullus, Kristian" sort="Bullus, Kristian" uniqKey="Bullus K" first="Kristian" last="Bullus">Kristian Bullus</name>
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<author><name sortKey="Drummond, Katherine J" sort="Drummond, Katherine J" uniqKey="Drummond K" first="Katherine J" last="Drummond">Katherine J. Drummond</name>
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<author><name sortKey="Trost, Nicholas" sort="Trost, Nicholas" uniqKey="Trost N" first="Nicholas" last="Trost">Nicholas Trost</name>
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<series><title level="j">Journal of neurologic physical therapy : JNPT</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term>
<term>Benign Paroxysmal Positional Vertigo (complications)</term>
<term>Benign Paroxysmal Positional Vertigo (diagnosis)</term>
<term>Cerebellar Neoplasms (complications)</term>
<term>Cerebellar Neoplasms (diagnosis)</term>
<term>Diagnosis, Differential (MeSH)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Hydrocephalus (complications)</term>
<term>Hydrocephalus (diagnosis)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Nystagmus, Pathologic (diagnosis)</term>
<term>Nystagmus, Pathologic (etiology)</term>
<term>Semicircular Canals (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Canaux semicirculaires osseux (MeSH)</term>
<term>Diagnostic différentiel (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Hydrocéphalie (complications)</term>
<term>Hydrocéphalie (diagnostic)</term>
<term>Mâle (MeSH)</term>
<term>Nystagmus pathologique (diagnostic)</term>
<term>Nystagmus pathologique (étiologie)</term>
<term>Tumeurs du cervelet (complications)</term>
<term>Tumeurs du cervelet (diagnostic)</term>
<term>Vertige positionnel paroxystique bénin (complications)</term>
<term>Vertige positionnel paroxystique bénin (diagnostic)</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Benign Paroxysmal Positional Vertigo</term>
<term>Cerebellar Neoplasms</term>
<term>Hydrocephalus</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Benign Paroxysmal Positional Vertigo</term>
<term>Cerebellar Neoplasms</term>
<term>Hydrocephalus</term>
<term>Nystagmus, Pathologic</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Hydrocéphalie</term>
<term>Nystagmus pathologique</term>
<term>Tumeurs du cervelet</term>
<term>Vertige positionnel paroxystique bénin</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Nystagmus, Pathologic</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Nystagmus pathologique</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Diagnosis, Differential</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Semicircular Canals</term>
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<keywords scheme="MESH" qualifier="complications" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Canaux semicirculaires osseux</term>
<term>Diagnostic différentiel</term>
<term>Femelle</term>
<term>Humains</term>
<term>Hydrocéphalie</term>
<term>Mâle</term>
<term>Tumeurs du cervelet</term>
<term>Vertige positionnel paroxystique bénin</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND AND PURPOSE</b>
</p>
<p>Benign paroxysmal positional vertigo (BPPV) is the most common cause of positional vertigo. The term "benign" is consistent with a peripheral vestibular disorder that does not carry the potentially sinister sequelae of a central nervous system (CNS) cause. However, in 12% to 20% of cases, positional vertigo may be attributed to CNS pathology, including tumors of the cerebellum.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CASE DESCRIPTION</b>
</p>
<p>Here, we present a series of 3 cases in which positional vertigo and nystagmus were the only presenting features in 2 cases of cerebellar tumor and 1 case of obstructive hydrocephalus.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>INTERVENTION</b>
</p>
<p>All patients underwent surgical intervention for removal of posterior fossa tumors or posterior fossa decompression for obstructive hydrocephalus. Following surgery, all 3 patients underwent a period of vestibular rehabilitation for postoperative motion sensitivity and balance impairment.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>OUTCOMES</b>
</p>
<p>Despite the continuing presence of central positioning nystagmus, all 3 patients recovered well, putatively with the aid of vestibular rehabilitation.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>DISCUSSION</b>
</p>
<p>The presence of central positioning nystagmus may be the sole presenting feature of serious neurological conditions such as posterior fossa tumor. It is recommended that a diagnosis of BPPV can only be made if Dix-Hallpike or supine roll maneuver elicits nystagmus that is consistent with BPPV. Any features of the nystagmus, which are not consistent with BPPV, should raise suspicion of central pathology, and warrant further investigation.Video Abstract available for more insights from the authors (see Video Abstract, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A265).</p>
</div>
</front>
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<Abstract><AbstractText Label="BACKGROUND AND PURPOSE">Benign paroxysmal positional vertigo (BPPV) is the most common cause of positional vertigo. The term "benign" is consistent with a peripheral vestibular disorder that does not carry the potentially sinister sequelae of a central nervous system (CNS) cause. However, in 12% to 20% of cases, positional vertigo may be attributed to CNS pathology, including tumors of the cerebellum.</AbstractText>
<AbstractText Label="CASE DESCRIPTION">Here, we present a series of 3 cases in which positional vertigo and nystagmus were the only presenting features in 2 cases of cerebellar tumor and 1 case of obstructive hydrocephalus.</AbstractText>
<AbstractText Label="INTERVENTION">All patients underwent surgical intervention for removal of posterior fossa tumors or posterior fossa decompression for obstructive hydrocephalus. Following surgery, all 3 patients underwent a period of vestibular rehabilitation for postoperative motion sensitivity and balance impairment.</AbstractText>
<AbstractText Label="OUTCOMES">Despite the continuing presence of central positioning nystagmus, all 3 patients recovered well, putatively with the aid of vestibular rehabilitation.</AbstractText>
<AbstractText Label="DISCUSSION">The presence of central positioning nystagmus may be the sole presenting feature of serious neurological conditions such as posterior fossa tumor. It is recommended that a diagnosis of BPPV can only be made if Dix-Hallpike or supine roll maneuver elicits nystagmus that is consistent with BPPV. Any features of the nystagmus, which are not consistent with BPPV, should raise suspicion of central pathology, and warrant further investigation.Video Abstract available for more insights from the authors (see Video Abstract, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A265).</AbstractText>
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<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Power</LastName>
<ForeName>Laura</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Balance Disorders and Ataxia Service, The Royal Victorian Eye and Ear Hospital, Melbourne, Australia (L.P., D.J.S.); Florey Institute of Neuroscience and Mental Health, Melbourne, Australia (L.P., D.J.S.); Dizzy Day Clinics, Melbourne, Australia (L.P., K.M.); Department of Neurosurgery (K.B.) and Medical Imaging Department (N.T.), St Vincents Hospital, Melbourne, Australia; Department of Neurosurgery, Royal Melbourne Hospital, and Department of Surgery, University of Melbourne, Australia (K.J.D.); and Neuroscience Department, Cerebellar Ataxia Clinic, Alfred Health, Melbourne, Australia (D.J.S.).</Affiliation>
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<QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName>
<QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName>
</MeshHeading>
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</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
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<MeshHeading><DescriptorName UI="D009759" MajorTopicYN="N">Nystagmus, Pathologic</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName>
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<tree><noCountry><name sortKey="Bullus, Kristian" sort="Bullus, Kristian" uniqKey="Bullus K" first="Kristian" last="Bullus">Kristian Bullus</name>
<name sortKey="Drummond, Katherine J" sort="Drummond, Katherine J" uniqKey="Drummond K" first="Katherine J" last="Drummond">Katherine J. Drummond</name>
<name sortKey="Murray, Kate" sort="Murray, Kate" uniqKey="Murray K" first="Kate" last="Murray">Kate Murray</name>
<name sortKey="Szmulewicz, David J" sort="Szmulewicz, David J" uniqKey="Szmulewicz D" first="David J" last="Szmulewicz">David J. Szmulewicz</name>
<name sortKey="Trost, Nicholas" sort="Trost, Nicholas" uniqKey="Trost N" first="Nicholas" last="Trost">Nicholas Trost</name>
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<country name="Australie"><region name="Victoria (État)"><name sortKey="Power, Laura" sort="Power, Laura" uniqKey="Power L" first="Laura" last="Power">Laura Power</name>
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