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Bilateral vestibulopathy presaging clinically probable multisystem atrophy
Uma Ravishankar1, Rithvik Ramesh2, Shankar Venkatasubramanian1
1Neurology, Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India.
BMJ Case Reports
|June 12, 2023
Summary
Bilateral vestibulopathy can precede multisystem atrophy (MSA) diagnosis by over a year. Early re-evaluation for parkinsonism and cerebellar signs is crucial in idiopathic cases.
Area of Science:
- Neurology
- Neuroscience
- Otolaryngology
Background:
- Bilateral vestibulopathy is a condition affecting balance, often diagnosed through investigations.
- Its causes are diverse, including neurodegenerative diseases, but many cases remain idiopathic.
- Early symptoms can be subtle and lack clear lateralizing signs.
Observation:
- A case study of an elderly male with progressive bilateral vestibulopathy is presented.
- The patient was diagnosed with clinically probable multisystem atrophy (MSA) 1.5 years after initial vestibulopathy symptoms.
- This highlights a potential early presentation of MSA.
Findings:
- Bilateral vestibulopathy may serve as an early indicator of underlying neurodegeneration.
- The study suggests a potential link between idiopathic bilateral vestibulopathy and the early stages of MSA.
- Lack of lateralizing signs can mask the underlying neurological condition.
Implications:
- Clinicians should consider serial re-evaluation for parkinsonism and cerebellar signs in patients with idiopathic bilateral vestibulopathy.
- Bilateral vestibulopathy could be an early premonitory syndrome for MSA, akin to anosmia or constipation.
- This understanding may improve early diagnosis and management of MSA.
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