一病例報告：周邊性眩暈續發外側延髓及小腦梗塞

Peripheral Vertigo Followed by Lateral Medullary and Cerebellar Infarction: A Case Report

一位57歲男性，因右側前庭神經炎而住院，該周邊性眩暈在2日後痊癒，順利出院。然而，出院後隔日卻又發作另一次的眩暈，合併左側Wallenburg氏症候群之症狀及徵候，包括打嗝、左側眼皮下垂、交叉感覺徵候（左側面部、右側肢體及右側軀幹感覺減弱）、左半邊味覺減弱、左側肢體辨距不能以及寬大步伐等。經影像學檢查後，證實為急性左外側延髓及小腦梗塞。本個案顯示即使是已經確診為前庭神經炎所致之周邊性眩暈，仍有可能會在短時間內續發腦梗塞所致之中樞性眩暈。因此，我們在面對眩暈患者時，不僅要分辨是周邊性或中樞性，還要預測未來注意其是否有發生腦梗塞之可能，期能儘早提供必要的預防及治療。

A 57-year-old man was admitted due to right vestibular neuritis. His peripheral vertigo remitted in two days; however, central vertigo occurred one day after he was discharged in stable condition. There were also symptoms and signs of left Wallenburg's syndrome including singultus, left ptosis, cross sensory defects (left hemifacial, right limb and hemitruncal hypesthesia), left hemiglossal dysguesia, left limb dysmetria and wide-based gait. After imaging studies were performed, he was diagnosed with acute left lateral medullary and cerebellar infarction related central vertigo. In this case, brain infarction related central vertigo followed shortly after vestibular neuritis related peripheral vertigo had been resolved. We hope to provide at-risk patients with preventive health care as early as possible.