Isolated tonsilar infarction presenting with positional vertigo and nystagmus
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Eun Hye Oh1
Seo-Young Choi2
Kwang-Dong Choi2
Jae-Hwan Choi1
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1.Department of Neurology, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsanSouth Korea
2.Department of Neurology, Pusan National University HospitalPusan National University School of Medicine and Biomedical Research InstituteBusanSouth Korea
Letter to the Editors
First Online: 17 July 2019
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Dear Sirs,

The flocculus and paraflocculus (or tonsil) play a pivotal role in control of eye movements [1]. Based on animal experiment, it is suggested that the flocculus is more integral in governing vestibulo-ocular reflexes (VORs), whereas the tonsil mainly contributes to smooth pursuit (SP) [2, 3]. In humans, however, an isolated lesion of the tonsil is sparse [4, 5], and oculomotor findings of the tonsil lesion have been explored only in one patient [4]. We describe oculomotor abnormalities in a patient with positional vertigo as a result of unilateral infarction of the tonsil, and compare results with a previously reported patient [4].

A 71-year-old man with hypertension and diabetes mellitus developed positional vertigo. The vertigo was induced when his head was turned to either side in supine position. He also reported nausea and vomiting, but denied other neurological symptoms. Eye movement recording using video-oculography showed no spontaneous and gaze-evoked nystagmus. In...
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Notes
Compliance with ethical standards
Conflicts of interest
We have no disclosure of any competing interest.

Ethical standards
All the experiments followed the tenets of the Declaration of Helsinki and this study was approved by Institutional Review Board.

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© Springer-Verlag GmbH Germany, part of Springer Nature 2019
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Cite this article as:
Oh, E.H., Choi, SY., Choi, KD. et al. J Neurol (2019) 266: 2578. https://doi.org/10.1007/s00415-019-09468-w
Received
12 April 2019
 Revised
10 July 2019
 Accepted
11 July 2019
 First Online
17 July 2019
 DOI
https://doi.org/10.1007/s00415-019-09468-w
 Publisher Name
Springer Berlin Heidelberg
 Print ISSN
0340-5354
 Online ISSN
1432-1459
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