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Vertigo and imbalance caused by a small lesion in the anterior insula

E S Papathanasiou1, S S Papacostas, M Charalambous

  • 1Department of Clinical Neurophysiology, The Cyprus Institute of Neurology & Genetics, 6 International Airport Avenue, P.O. Box 23462, Nicosia 1683, Cyprus. neurophy@cing.ac.cy

Electromyography and Clinical Neurophysiology
|August 22, 2006
PubMed

Insights

A small lesion in the right anterior insula caused vertigo and imbalance. This case suggests the anterior insula plays a role in vestibular function and smooth pursuit control.

Area of Science:

  • Neuroscience
  • Vestibular System
  • Neuroimaging

Background:

  • The precise location of the human vestibular cortex remains undetermined.
  • Isolated insular lesions are rare clinical occurrences.

Observation:

  • A patient presented with recurrent vertigo and imbalance.
  • A small lesion was identified in the right anterior insula via MRI.
  • Vestibular evoked potentials and audiometry ruled out peripheral and brainstem pathologies.

Findings:

  • The patient exhibited abnormal video nystagmography with high slow-phase velocities and impaired saccadic tracking.
  • The anterior insula lesion correlated with the observed vestibular symptoms and signs.
  • This is the first reported instance of vestibular dysfunction linked to an anterior insula lesion.

Implications:

  • The anterior insula may be a critical component of the human vestibular cortex.
  • This finding suggests the anterior insula is involved in the neural pathways controlling smooth pursuit eye movements.
  • Further research is warranted to elucidate the insula's role in vestibular processing.

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