Multiple sclerosis attack case presenting with pseudo-vestibular neuritis

Abstract

Purpose

Pseudo-vestibular neuritis is a clinical diagnosis for patients presenting with acute vestibular syndrome due to a central pathology.

Case report

We reported a case of multiple sclerosis characterized by pseudo-vestibular neuritis. Our case was a 32-year-old male patient. The patient, who was diagnosed with multiple sclerosis in September 2019, came to the emergency clinic in January 2020 with the complaint of severe vertigo, vomiting-nausea. A newly developed demyelinating plaque was detected in the left vestibular nucleus in cranial MRI. The patient had no hearing loss. On examination of the patient, nystagmus findings supporting peripheral vestibular involvement were present on the left side. Neurologic examination showed left-sided hyperactive deep tendon reflexes, Achilles clonus, dysmetria, ataxia to the left and plantar reflex with extensor response on the left. Video head impulse test and cervical evoked myogenic potential tests were performed. Vestibular hypofunction was present on the left side. Steroid pulse therapy was administered as 1000 mg/day, i.v for 7 days. After treatment, his complaints decreased. In addition, there was an improvement in examination findings.

Conclusion

Multiple sclerosis is shown to be an etiological factor in patients with pseudo-vestibular neuritis.

Keywords:

• Multiple sclerosis
• pseudo-vestibular neuritis
• vertigo
• video head impulse test
• cervical evoked myogenic potential

Acknowledgements

The authors would like to thank to Mert YILDIZ in University of Health of Sciences, Umraniye Training and Research Hospital, Odiology Department for CVEMP and pure tone audiometry test.

Disclosure statement

None of the authors have a conflict of interest.

Ethical approval

All procedures performed in study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.