Neurology, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India.
Neurology, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India
BMJ Case Rep. 2023 Jun 12;16(6):e254472. doi: 10.1136/bcr-2022-254472.
Bilateral vestibulopathy is a clinical diagnosis backed by investigative confirmation, which can be masked by the lack of lateralising signs. It has a broad aetiological spectrum including neurodegenerative conditions, though many such cases also have unknown aetiology. We present the case of an elderly gentleman who presented with progressive bilateral vestibulopathy nearly 1.5 years prior to his eventual diagnosis of clinically probable multisystem atrophy. This case highlights the need to serially re-evaluate for parkinsonism and cerebellar signs in idiopathic bilateral vestibulopathy and raises a possibility that bilateral vestibulopathy, similar to constipation or anosmia, could be an early syndrome presaging the onset of overt extrapyramidal or cerebellar symptoms in patients with multisystem atrophy.
双侧前庭病是一种临床诊断，有调查结果支持，但可能因缺乏侧化体征而被掩盖。它的病因广泛，包括神经退行性疾病，但许多此类病例的病因仍不清楚。我们报告了一例老年男性患者，他在最终诊断为临床可能的多系统萎缩前近 1.5 年出现进行性双侧前庭病。这个病例强调了在特发性双侧前庭病中需要定期重新评估帕金森病和小脑体征的必要性，并提出了一种可能性，即双侧前庭病类似于便秘或嗅觉丧失，可能是多系统萎缩患者出现明显锥体外系或小脑症状之前的早期综合征。
