Cortical Calcification of the Temporal Lobe Presenting as Recurrent Paroxysmal Room Tilt Illusion

Abstract

During the paroxysmal tilt illusion (PRTI) the patient experiences that the room is turned upside down or tilted to one side in the frontal plane. This rare symptom is assumed to reflect otolith dysfunction and has been reported in association with peripheral vestibular, brainstem and cortical lesions. In the cortex, PRTI has usually been described as a part of complex partial seizures, mainly of parieto-occipital origin. However, only a few of the cortical lesions responsible for seizures have been documented by neuroimaging. We report a patient with a posterior temporal cortical calcification who presented with recurrent monosymptomatic PRTIs that were assumed to be partial seizures. Isolated PRTI should thus be recognized as an organic complaint and prompt the search for a structural brain abnormality.

KEYWORDS:

• Brain calcification
• paroxysmal
• room-tilt illusion