Unusual caloric responses in a patient with a fourth ventricular ependymoma

Abstract

The caloric test is probably the most widely used clinical test of vestibular function. A unilateral decrease in response to cold and warm water reliably indicates a unilateral peripheral vestibular lesion. Central signs on caloric testing are less common but important to recognize because they are often associated with lesions of the brainstem. We describe a patient with a tumor originating in the floor of the fourth ventricle who presented with premature reversal after cold stimulation on one side and perverted nystagmus after cold stimulation of the other side.

Keywords Premature caloric reversal – Perverted nystagmus – Central caloric findings