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Vestibular and Ocular Motor Properties in Cerebellar Infarction
Published online by Cambridge University Press: 04 March 2025
Abstract
Background:
The study aimed to determine the patterns of the vestibular and ocular motor findings in cerebellar infarction (CI).
Methods:
We retrospectively analyzed vestibular and ocular motor test results in 23 CI patients and 32 acute unilateral vestibulopathy (AUVP) patients.
Results:
Among CI cases, the posterior inferior cerebellar artery (PICA) was the most commonly affected territory. Vertigo is predominantly observed in patients with infarctions affecting PICA or anterior inferior cerebellar artery (AICA). Lesions involving the superior cerebellar artery (SCA) mainly result in dizziness. Saccadic intrusion and oscillation, abnormal bilateral smooth pursuit (SP) and abnormal saccades were more prevalent in the CI group than in the AUVP group (all p < 0.05). Horizontal saccades were abnormal in 11 patients (47.8%) with CI. All AUVP patients had normal horizontal saccades. Horizontal SP was impaired in 13 patients (56.5%) with CI, with decreased gain toward both sides in 10 and toward 1 side in 3. Impaired horizontal SP was noted in nine patients (28.1%) with AUVP, with decreased gain toward the contralesional side in all cases. A total of 26.3% (5/19) of patients with CI exhibited subjective visual vertical (SVV) deviation toward the affected side and 31.6% (6/19) toward the unaffected side. In patients with AUVP, 70.0% (21/30) showed SVV deviation toward the affected side.
Conclusions:
Vertigo is mainly seen in PICA or AICA infarctions. SCA lesions mostly cause dizziness. Saccadic intrusion and oscillation, abnormal bilateral SP and abnormal saccades contribute to the diagnosis of CI. Moreover, SVV deviation varies depending on the cerebellar structures involved.
Résumé
Les propriétés motrices vestibulaires et oculaires dans l’infarctus du cervelet.
L’étude visait à déterminer les types de troubles moteurs vestibulaires et oculaires dans l’infarctus du cervelet (IC).
Il s’agit d’une étude rétrospective, portant sur les résultats d’examens moteurs vestibulaires et oculaires, obtenus chez 23 patients ayant subi un IC et chez 32 patients atteints d’une vestibulopathie unilatérale aiguë (VUA).
Dans les cas de l’IC, le territoire le plus souvent affecté était celui irrigué par l’artère cérébelleuse postéro-inférieure (ACPI). Les vertiges étaient la manifestation la plus fréquente, observée chez les patients ayant subi un infarctus de l’ACPI ou de l’artère cérébelleuse antéro-inférieure (ACAI). Les lésions de l’artère cérébelleuse supérieure (ACS) se traduisaient surtout par des étourdissements. Les intrusions et les oscillations saccadées, la poursuite oculaire continue (POC) bilatérale anormale et les saccades anormales étaient plus fréquentes dans le groupe de l’IC que dans celui de la VUA (tous sujets confondus : p < 0,05). Les saccades horizontales étaient anormales chez 11 patients (47,8 %) ayant subi un IC, mais elles étaient toutes normales chez les patients atteints d’une VUA. Treize patients (56,5 %) dans le groupe de l’IC présentaient une altération de la POC horizontale, accompagnée d’une diminution du gain dans les deux directions chez 10 patients et dans une direction chez 3 patients. Une POC horizontale anormale a été observée chez 9 patients (28,1 %) atteints d’une VUA, accompagnée d’une diminution du gain vers le côté controlésionel dans tous les cas. Par ailleurs, 26,3 % des patients (5/19) ayant subi un IC présentaient une déviation de la verticale visuelle subjective (VVS) vers le côté affecté, et 31,6 % (6/19), vers le côté sain. Enfin, 70,0 % (21/30) des patients souffrant d’une VUA montraient une déviation de la VVS vers le côté atteint.
Les vertiges s’observent principalement dans les infarctus de l’ACPI ou de l’ACAI. Les lésions de l’ACS causent surtout des étourdissements. La présence d’intrusions et d’oscillations saccadées, d’une poursuite oculaire continue (POC) bilatérale anormale et de saccades anormales facilite la pose du diagnostic d’IC. Enfin, la déviation de la VVS varie selon l’atteinte des structures cérébelleuses.
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- © The Author(s), 2025. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation
Footnotes
Xia Ling and Liying Chang contributed equally to this article.
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