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Acute thrombosis of the carotid artery associated with positional nystagmus at multiple planes
Sertaç Yetişer1, Yaşar Kütükçü2, Kutlay Kahraman3
1Anadolu Medical Center, Dept of ORL & HNS, Kocaeli, 41400, Turkey.
Objective:
An acute onset central pathology without any clear neurological symptoms may mimic peripheral vestibular problem in an emergency setting. A 54-year-old man suddenly developed dizziness without any cranial nerve symptoms, paresis, cerebellar signs or sensory disturbances except upbeat positional nystagmus at multiple provoked positions which alerted for a possible acute central pathology.
Findings:
An instantaneous magnetic resonance imaging and angiography studies further showed obstruction of the left internal carotid artery above the bifurcation. The patient's subsequent prognosis was consistent with good recovery following anti-coagulant therapy. A follow-up MRI and angiography showed resolution of thrombosis.
Conclusion:
It should be kept in mind that positional nystagmus is likely to occur in central pathologies. Differentiation between benign paroxysmal positional vertigo and central positioning nystagmus is critical.
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