Diagnosis of Isolated Central Vertigo: Report for a Series Cases

Risk Manag Healthc Policy. 2024 Dec 18:17:3197-3205. doi: 10.2147/RMHP.S474047. eCollection 2024.

Abstract

Vertigo, including central and peripheral causes, is one of the common symptoms in patients who are admitted to neurological outpatient and emergency rooms. Despite the advancements in imaging techniques in recent years, central vertigo is difficult to identify and is often misdiagnosed in clinical practice. In this study, 4 patients were admitted to the hospital with complaints of dizziness or vertigo. Information about their symptoms, physical examinations and imaging were collected. Two patients were accurately diagnosed using diffusion-weighted imaging (DWI), a specific type of brain MRI. They received targeted treatments, which led to significant improvement, and were discharged nearly cured within a week. One patient with dorsolateral medullary infarction was misdiagnosed due to atypical symptoms, such as vertigo without the typical lateral medullary syndrome signs, and was discharged with a mild swallowing disorder after 2 weeks of treatment. One patient was diagnosed with both central and peripheral vertigo. It was observed that the symptoms of isolated vertigo caused by an acute lacunar infarction resolved more quickly than the accompanying physical symptoms. In summary, more attention should be paid to the diagnosis of isolated central vertigo, as early identification and intervention can improve a patient's prognosis and reduce medical expenses.

Keywords: brain MRI; case series; central vestibular disorders; cerebral infarction; isolated central vertigo; physical examination.

Publication types

  • Case Reports

Grants and funding

The study is funded by the Natural Science Foundation of Hunan Province General Program (2020JJ4477) and Excellent Youth Program of Hunan Provincial Education Department (18B234). Funding agencies did not play a role in study design, data collection, analysis and interpretation, and manuscript writing.