Vestibular and Ocular Motor Properties in Cerebellar Infarction

Area of Science:

• Neuroscience
• Neurology
• Ophthalmology

Background:

• Cerebellar infarction (CI) is a significant neurological event.
• Understanding vestibular and ocular motor findings in CI is crucial for diagnosis.
• Distinguishing CI from other vestibular disorders like acute unilateral vestibulopathy (AUVP) can be challenging.

Purpose of the Study:

• To delineate the characteristic patterns of vestibular and ocular motor dysfunction in patients with cerebellar infarction (CI).
• To compare these findings with those observed in acute unilateral vestibulopathy (AUVP) to identify diagnostic markers.
• To investigate the relationship between the location of cerebellar lesions and specific clinical presentations.

Main Methods:

• Retrospective analysis of vestibular and ocular motor test results.
• Inclusion of 23 patients diagnosed with cerebellar infarction (CI).
• Comparison with 32 patients diagnosed with acute unilateral vestibulopathy (AUVP).

Main Results:

• Posterior inferior cerebellar artery (PICA) territory infarctions were most common in CI.
• Vertigo was prevalent in PICA or anterior inferior cerebellar artery (AICA) infarctions; dizziness was more common with superior cerebellar artery (SCA) lesions.
• Abnormalities in saccades, smooth pursuit (SP), and saccadic intrusions were significantly more frequent in CI patients compared to AUVP patients (p < 0.05).
• Horizontal saccades were abnormal in 47.8% of CI patients versus 0% in AUVP.
• Horizontal smooth pursuit was impaired in 56.5% of CI patients, often bilateral, compared to 28.1% in AUVP, typically unilateral.
• Subjective visual vertical (SVV) deviation patterns differed between CI and AUVP, with CI showing deviations to both affected and unaffected sides.

Conclusions:

• Vertigo is a key symptom in PICA or AICA infarctions, while dizziness suggests SCA lesions.
• Ocular motor signs, including saccadic intrusions, abnormal bilateral smooth pursuit, and abnormal saccades, are valuable for diagnosing CI.
• Subjective visual vertical deviation patterns are variable in CI and depend on the specific cerebellar structures affected.