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Complete ocular tilt reaction with subjective visual vertical tilt in a patient with a medial prefrontal cortex lesion: a case report

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Author(s)
Hyung LeeHyun Ah Kim
Keimyung Author(s)
Lee, HyungKim, Hyun Ah
Department
Dept. of Neurology (신경과학)
Journal Title
Res Vestib Sci
Issued Date
2024
Volume
23
Issue
1
Keyword
Vestibular systemFrontal lobeSkew deviation
Abstract
A 61-year-old male patient undergoing chemotherapy for esophageal cancer presented with symptoms of rightward tilting while both sitting and walking. A neurological examination revealed a head tilt, skew deviation with hypertrophy of the left eye, and a rightward shift in his gait. No spontaneous nystagmus was observed, and the vestibulo-ocular reflex was normal. Magnetic resonance imaging of the head revealed a suspected metastatic lesion in the right medial prefrontal cortex. Following the initiation of levetiracetam treatment, the patient demonstrated marked improvement, with the resolution of both head tilt and skew deviation within 1 month. Traditionally, the ocular tilt reaction has been attributed to unilateral or asymmetric dysfunction of the graviceptive pathways extending from the utricle to the upper midbrain lesions. However, this case highlights the potential involvement of the prefrontal cortex in the ocular tilt reaction. Further research is warranted on the role of the prefrontal cortex within the vestibular system.
Keimyung Author(s)(Kor)
이형
김현아
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2093-5501
Source
https://e-rvs.org/journal/view.php?number=966
DOI
10.21790/rvs.2023.136
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45384
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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