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Case report: Spiller syndrome initially mimicking vestibular neuritis
Spiller syndrome is a rare subtype of medial medullary infarction (MMI). Herein, we report on a patient with progressing stroke who presented with the initial features of acute peripheral vestibulopathy and MMI (Spiller syndrome), as confirmed by magnetic resonance imaging (MRI). A 42-year-old man e...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868901/ https://www.ncbi.nlm.nih.gov/pubmed/36698901 http://dx.doi.org/10.3389/fneur.2022.1072220 |
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author | Wang, Huiyuan Shi, Tianming Shang, Yafei Chen, Xinyi Xu, Jie Geng, Yu |
author_facet | Wang, Huiyuan Shi, Tianming Shang, Yafei Chen, Xinyi Xu, Jie Geng, Yu |
author_sort | Wang, Huiyuan |
collection | PubMed |
description | Spiller syndrome is a rare subtype of medial medullary infarction (MMI). Herein, we report on a patient with progressing stroke who presented with the initial features of acute peripheral vestibulopathy and MMI (Spiller syndrome), as confirmed by magnetic resonance imaging (MRI). A 42-year-old man experienced acute persistent vertigo with nausea, vomiting, and severe gait instability for 6 h before presenting to the emergency department. He exhibited spontaneous right-beating horizontal-torsional nystagmus that intensified on rightward gaze. The patient fell to the left side during the Romberg test. Cranial computed tomography (CT) performed immediately upon admission did not provide evidence for ischemia or hemorrhage of the brainstem and cerebellum; however, the symptoms underwent exacerbation 4 h after admission, manifesting as left-sided limb weakness and dysarthria, without dysphagia. Furthermore, bedside examination revealed difficulty in extending the tongue to the right, positive left Babinski's sign, and abnormal vibration and position sense in the paralyzed limb. Head impulse test recording revealed a normal gain in the vestibulo-ocular reflex, and numerous consistent covert corrective saccades were captured upon turning the head to the left side. Cranial MRI depicted an acute infarct confined to the right side of the medial medulla, which met the diagnostic criteria for Spiller syndrome. Our study underscores the importance of considering the possibility of a nucleus prepositus hypoglossi lesion even if the signs and symptoms support the diagnosis of peripheral lesions in patients with acute vestibular syndrome exhibiting vascular risk factors. |
format | Online Article Text |
id | pubmed-9868901 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98689012023-01-24 Case report: Spiller syndrome initially mimicking vestibular neuritis Wang, Huiyuan Shi, Tianming Shang, Yafei Chen, Xinyi Xu, Jie Geng, Yu Front Neurol Neurology Spiller syndrome is a rare subtype of medial medullary infarction (MMI). Herein, we report on a patient with progressing stroke who presented with the initial features of acute peripheral vestibulopathy and MMI (Spiller syndrome), as confirmed by magnetic resonance imaging (MRI). A 42-year-old man experienced acute persistent vertigo with nausea, vomiting, and severe gait instability for 6 h before presenting to the emergency department. He exhibited spontaneous right-beating horizontal-torsional nystagmus that intensified on rightward gaze. The patient fell to the left side during the Romberg test. Cranial computed tomography (CT) performed immediately upon admission did not provide evidence for ischemia or hemorrhage of the brainstem and cerebellum; however, the symptoms underwent exacerbation 4 h after admission, manifesting as left-sided limb weakness and dysarthria, without dysphagia. Furthermore, bedside examination revealed difficulty in extending the tongue to the right, positive left Babinski's sign, and abnormal vibration and position sense in the paralyzed limb. Head impulse test recording revealed a normal gain in the vestibulo-ocular reflex, and numerous consistent covert corrective saccades were captured upon turning the head to the left side. Cranial MRI depicted an acute infarct confined to the right side of the medial medulla, which met the diagnostic criteria for Spiller syndrome. Our study underscores the importance of considering the possibility of a nucleus prepositus hypoglossi lesion even if the signs and symptoms support the diagnosis of peripheral lesions in patients with acute vestibular syndrome exhibiting vascular risk factors. Frontiers Media S.A. 2023-01-09 /pmc/articles/PMC9868901/ /pubmed/36698901 http://dx.doi.org/10.3389/fneur.2022.1072220 Text en Copyright © 2023 Wang, Shi, Shang, Chen, Xu and Geng. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Wang, Huiyuan Shi, Tianming Shang, Yafei Chen, Xinyi Xu, Jie Geng, Yu Case report: Spiller syndrome initially mimicking vestibular neuritis |
title | Case report: Spiller syndrome initially mimicking vestibular neuritis |
title_full | Case report: Spiller syndrome initially mimicking vestibular neuritis |
title_fullStr | Case report: Spiller syndrome initially mimicking vestibular neuritis |
title_full_unstemmed | Case report: Spiller syndrome initially mimicking vestibular neuritis |
title_short | Case report: Spiller syndrome initially mimicking vestibular neuritis |
title_sort | case report: spiller syndrome initially mimicking vestibular neuritis |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868901/ https://www.ncbi.nlm.nih.gov/pubmed/36698901 http://dx.doi.org/10.3389/fneur.2022.1072220 |
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