Rotational vertigo in embolic stroke of the vestibular and auditory cortices

Neurology. 1995 Jan;45(1):42-4. doi: 10.1212/wnl.45.1.42.

Abstract

We describe the unique case of a woman with embolic infarction within the right middle cerebral artery territory who had nonepileptic rotational vertigo, nausea, and unsteady gait that gradually resolved within a week. A well-demarcated lesion of the posterior insula (homologous to parieto-insular vestibular cortex in monkeys) was probably the cause. This is supported by a contraversive tilt of perceived vertical and by involvement of the adjacent auditory (Heschl's) cortex. Dipole source analysis of late auditory evoked potentials revealed a decreased amplitude of a dipole source in the right insular cortex, whereas two other dipoles situated in the temporal lobe showed symmetric activity.

Publication types

  • Case Reports

MeSH terms

  • Acoustic Stimulation
  • Adult
  • Auditory Cortex / pathology*
  • Cerebral Infarction / diagnosis
  • Cerebral Infarction / physiopathology*
  • Evoked Potentials, Auditory
  • Female
  • Functional Laterality
  • Gadolinium DTPA
  • Humans
  • Intracranial Embolism and Thrombosis / diagnosis
  • Intracranial Embolism and Thrombosis / physiopathology*
  • Magnetic Resonance Imaging
  • Organometallic Compounds
  • Pentetic Acid / analogs & derivatives
  • Rotation
  • Vertigo / etiology*
  • Vestibule, Labyrinth / pathology*

Substances

  • Organometallic Compounds
  • Pentetic Acid
  • Gadolinium DTPA