Zeyen Thomas, Klockgether Thomas, Schaub Christina, Paech Daniel, Vogt Timo, Kurzwelly Delia
Department of Neurology, University Hospital Bonn, Bonn, Germany.
Department of Neuroradiology, University Hospital Bonn, Bonn, Germany.
Case Rep Neurol Med. 2025 May 8;2025:9611619. doi: 10.1155/crnm/9611619. eCollection 2025.
Pseudovestibular syndrome refers to central pathologies that mimic acute unilateral peripheral vestibulopathy, often posing a diagnostic challenge, particularly when key symptoms indicating a central origin are absent. The most common etiology is brain ischemia resulting from posterior inferior cerebellar artery occlusion. This article presents a rare case of a left paramedian cerebellar hemorrhage initially misdiagnosed as right-sided vestibular neuritis. Cerebellar hemorrhage can induce pseudovestibular syndrome by disrupting the connective fibers from the flocculus to the ipsilateral vestibular nucleus in the pons. Additionally, central pathologies affecting the vestibular system may occasionally manifest a pathological vestibulo-ocular reflex. This case report underscores the importance of considering potentially severe central-origin conditions in the differential diagnosis of seemingly benign unilateral peripheral vestibulopathy.
假性前庭综合征是指模拟急性单侧周围性前庭病的中枢性病变，常常带来诊断挑战，尤其是在缺乏提示中枢起源的关键症状时。最常见的病因是小脑后下动脉闭塞导致的脑缺血。本文介绍了一例罕见的左侧小脑旁正中出血病例，最初被误诊为右侧前庭神经炎。小脑出血可通过破坏从绒球到脑桥同侧前庭核的连接纤维而诱发假性前庭综合征。此外，影响前庭系统的中枢性病变偶尔可能表现出病理性前庭眼反射。本病例报告强调了在看似良性的单侧周围性前庭病的鉴别诊断中考虑潜在严重中枢起源疾病的重要性。
