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Vertigo with rebound nystagmus as an initial manifestation in a patient with basilar artery occlusion.

Huang CC, Young YH

Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, 1 Chang-Te St., Taipei, Taiwan.

Basilar artery occlusion (BAO) is generally associated with a high mortality rate and a poor functional outcome in survivors. Recently, we encountered a patient with BAO, initially manifesting as vertigo and rebound nystagmus, subsequently followed by bilateral sudden deafness and dysarthria and terminating in a coma state within an interval of 6 h. A review of his history showed he had had two episodes of transient vertigo 2 weeks before the major stroke, and the neurological decline of BAO was heralded by the vertiginous symptoms. Restated, patients with BAO often have transient vertiginous attacks preceding fatal stroke. Therefore, those with vertigo and nystagmus may be signaling a forthcoming stroke event, something that should be considered for clinicians seeing vertiginous patients.

Published 10 August 2005 in Eur Arch Otorhinolaryngol, 262(7): 576-9.
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