一精神分裂患者腦幹中風以眩暈及步態失調為表現－病例報告

Brainstem Stroke Manifesting as Vertigo and Ataxia in a Schizophrenic Patient - Case Report

黃琮瑋(Tsung-Wei Huang) ； 楊怡和(Yi-Ho Young)

《中華民國耳鼻喉科醫學雜誌》 36卷6期 (2001/10) Pp. 404-408

https://doi.org/10.6286/2001.36.6.404

摘要

眩暈被定義為一種動作的錯覺，而錯覺又是精神分裂患者的表徵之一。因此，面對一名精神分裂病人罹患眩暈時，如何鑑別診斷，便考驗精神科醫師與神經耳科醫師。最近我們經驗一例精神分裂患者罹患眩暈，前庭功能檢查出現兩側性注視眼振，及背地方向變換性頭位眼振。眼振電圖檢查出現許多中樞性徵象。前庭誘發肌性電位檢查，右側正常，左側呈陰性。經磁振掃描證實為，左側橋腦延腦交界處有海綿狀血管瘤出血合併血管畸形。病人在接受保守性治療後，眩暈在第2天後消失，而眼振則在1個月後消失。

關鍵字

眩暈 ； 中風 ； 精神分裂症 ； 眼振

並列摘要

Vertigo is defined as an illusion of movement, and may present as one of the symptoms of schizophrenia. Accordingly, vertigo poses a challenge for both psychiatrists and neurootologists when seen in a schizophrenic patient. Herein, a schizophrenic patient with a pontomedullary hemorrhage that manifested as acute vertigo is present. Three-dimensional videonystagmography found bilateral gaze nystagmus and apogeotrophic direction changing positional nystagmus. Electronystagmography revealed multiple central signs, and vestibular evoked myogenic potentials were absent on the side of the lesion. MRI identified a pontomedullary hemorrhage on the left side resulting from cavernous hemangioma with venous malformation. The vertigo subsided after conservative treatment, and the spontaneous nystagmus resolved one month later. In conclusion, vertigo in a schizophrenic patient presents unique history taking and diagnostic challenges.

並列關鍵字

vertigo ； stroke ； schizophrenia ； nystagmus