The vestibular system, essential for balance and spatial orientation, spans from the inner ear to various brain regions. Advances in imaging techniques have significantly enhanced our ability to diagnose and treat vestibular disorders. This review explores the anatomy of the vestibular system and evaluates the roles of high-resolution computed tomography (CT) and magnetic resonance imaging (MRI) in diagnosing structural abnormalities. CT is particularly useful for identifying bony labyrinth anomalies, temporal bone fractures, and superior canal dehiscence, though it has limitations in visualizing membranous labyrinth lesions. MRI, with its superior soft tissue resolution, is preferred for detecting retrocochlear lesions such as vestibular schwannomas, cerebellopontine angle tumors, and demyelinating diseases in the posterior fossa. Functional MRI also offers insights into the vestibular system’s functional aspects. The review emphasizes the increasing importance of imaging diagnostics in the effective management of vestibular system diseases, highlighting both structural and functional imaging modalities to improve patient outcomes.

The ultimate role of ocular movements is to keep the image of an object within the fovea and thereby prevent image slippage on the retina. Accurate evaluations of eye movements provide very useful information for understanding the functions of the oculomotor system and determining abnormalities therein. Such evaluations also play an important role in enabling accurate diagnoses by identifying the location of lesions and discriminating from other diseases. There are various types of ocular movements, and this article focuses on saccades, fast eye movements, smooth pursuit, and slow eye movements, which are the most important types of eye movements used in evaluations performed in clinical practice.

Citations

• COMPARISON OF RANDOM SACCADE TEST AND CLINICAL SACCADOMETRY TEST RESULTS OF HEALTHY ELDERLY AND YOUNG INDIVIDUALS
  Gülce KİRAZLI, Gökçe SAYGI UYSAL, Ece ÇINAR, Aykut ÖZDOĞAN, Şüheda BARAN, Fatih TEKİN
  Turkish Journal of Geriatrics.2025;[Epub]     CrossRef
• Analysis of Eye Movements in Adults with Spinal Muscular Atrophy
  Marek Krivošík, Zuzana Košutzká, Marián Šaling, Veronika Boleková, Rebeka Brauneckerová, Martin Gábor, Peter Valkovič
  Medicina.2025; 61(4): 571.     CrossRef

The ultimate purpose of eye movement is to maintain clear vision by ensuring that images of observed objects are focused on the fovea in the retina. Accurate evaluation of ocular movements, including nystagmus and saccadic intrusions, provides very useful information for determining the overall function and abnormality of the complex oculomotor system, from the peripheral vestibular system to the cerebrum. Eye movement tests are therefore essential for the accurate diagnosis of patients who complain of dizziness and imbalance. They help to predict lesion locations from the peripheral vestibular system to the central cerebral cortex and play an important role in differentiation from other diseases. The methodology of recording and interpreting ocular movements using video-oculography are described in this review article.

Citations

• Miller Fisher syndrome initially presented as bilateral internuclear ophthalmoplegia: a case report
  Sanghyun Kim, Jusuck Lee, Daewoong Bae
  Research in Vestibular Science.2025; 24(1): 46.     CrossRef
• Transcranial temporal interference stimulation precisely targets deep brain regions to regulate eye movements
  Mo Wang, Sixian Song, Dan Li, Guangchao Zhao, Yu Luo, Yi Tian, Jiajia Zhang, Quanying Liu, Pengfei Wei
  Neuroscience Bulletin.2025;[Epub]     CrossRef

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin’s lymphoma. Although progressive lymphadenopathy is a typical feature, extranodal involvement may also occur, including the gastrointestinal tract, skin, bone, thyroid, and testes. Central nervous system invasion is rare, so differentiating it from diseases such as inflammatory demyelinating disorder or infection is essential. DLBCL is therefore a challenge to diagnose, especially when the first findings are neurological symptoms. We report an unusual case of DLBCL that presented as transverse myelitis.

Background
The standardized autonomic function test has become widely available. However, there are no reference data for this test for the Korean population. This study explored reference data for sudomotor and cardiovagal function tests for the Korean population.
Methods
The sweat volume by quantitative sudomotor axon reflex test, heart-rate response to deep breathing (HRdb), expiration:inspiration (E:I) ratio, and Valsalva ratio (VR) were measured in 297 healthy Korean volunteers aged from 20 to 69 years. Multivariate regression analysis was performed to evaluate the effects of age, sex, and body mass index on these variables. The 2.5th, 5th, 10th, 90th, 95th, and 97.5th percentile values were obtained for each investigation.
Results
The sweat volume was higher in males than in females. The HRdb and E:I ratio were negatively correlated with age, and were higher in males than in females. The VR was negatively correlated with age, but it was not correlated with sex.
Conclusions
This study has provided data on the reference ranges for sudomotor and cardiovagal function tests in healthy Korean adults.

Citations

• Abnormal quantitative sudomotor axon reflex test results in patients with tinnitus as a possible indicator of small fiber neuropathy
  Hye Lim Lee, Hyun Ji Lyou, Jae-Jun Song, Chi Kyung Kim
  Frontiers in Neurology.2024;[Epub]     CrossRef
• Generalized anhidrosis with preganglionic sudomotor dysfunction in Fabry disease: a case report
  Eun Bin Cho, Seung Joo Kim, Tae-Won Yang, Heejeong Jeong, Changhyo Yoon, Seunguk Jung, Ki-Jong Park
  Clinical Autonomic Research.2021; 31(4): 585.     CrossRef
• Interpretation of Autonomic Function Test
  Kee Hong Park, Eun Hee Sohn
  Journal of the Korean Neurological Association.2021; 39(2): 61.     CrossRef

Thiamine deficiency can cause peripheral polyneuropathy and Wernicke’s encephalopathy. Wernicke’s encephalopathy is characterized by ataxia, ophthalmoplegia, nystagmus, and confusion, and typically presents acute and rapidly progressive course, whereas peripheral neuropathy associated with thiamine deficiency manifests chronic and slowly progressive one. However, acute and rapidly progressive axonal polyneuropathy combined with Wernicke’s encephalopathy is quite rare and unusual. Here, we describe a patient with Wernicke’s encephalopathy who presented with acute bilateral axonal neuropathy.

Dyskinesia con occur as a neurological abnormality due to stroke, and its incidence in stroke patients is reported be about 1%. It is possible to classify dyskinesia into one of the morphologic types already classified clinically. However, a specific type of dyskinesia can occur, one which does not fall into the existing morphologic types. We experienced sych a case of specific type dyskinesia, which couldn't be classified into the existing classification system. A 50-year-old man visited our hospital due to rhythmic dyskinesia of the right hand, which appeared during the resting state, and had developed one month after left subcortical infarction. Flexion and extension movements of the fingers at 3Hz appeared due to the impulse to move, however, this abnormal movement could be easily suppressed under the patients will. We suggested that the abnormal movement was similar to akathisia from the fact that if occurred due to the internal desire to move and that the patient could suppress dyskinesia. However, the rhythmic tendency and lack of medication history of antipsychotics suggested that the movement was not the typical form of akathisia. The present case may represent a new clinical type of movement disorder developed after stroke. Considering the clinical pattern of the present case and following a review of the literature, we believe that it can be labeled, post-stroke rhythmic akathisia.

The head thrust maneuver is a simple bedside test of the higher frequency vestibulo-ocular reflex, which is based on Ewald's second law. It is performed by grasping the patient's head and applying a brief, small-amplitude, high-acceleration head turn, first to one side and then to the other. The patient fixates on the examiner's nose and the examiner watches for corrective rapid eye movements (saccades), which are a sign of decreased vestibular response. The "catch-up" saccades after a head thrust in one direction indicate a peripheral vestibular lesion on that side (in the labyrinth or the 8th nerve including the root's entry zone in the brain stem). An individual pair of vertical semicircular canals can also be stimulated by turning the head to the right or left by 45�and then by rotating the head in the pitch plane relative to the body. Recent studies have suggested that assessment of individual semicircular canal function by head thrust test mayprovide useful information for anatomical and functional details of a variety of peripheral vestibulopathies and for predicting the prognosis of vestibular neuritis. In central vestibulopathy, the head thrust test may also be valuable sign to determine dysfunction of the central pathways from individual semicircular canals and its role for the development of diverse central nystagmus.

Two separate cranial nerve variants of Guillain-Barre syndrome(GBS) have been reported. One is Miller-Fisher syndrome,the other is polyneuritis cranialis. Involvement of the extraocular muscles in variants of GBS is well recognized,but complete external and internal opthalmoplegia is rare. Optic neuritis remains the only consistent, albeit very uncommon,evidence of inflammation of central nervous system myelin in GBS. This propose that GBS is part of a spectrumof central and peripheral inflammation.This case is an unusual clinical variant who had ptosis, opthalmoplegia, areflexia, ataxia, optic neurritis, markedoropharyngeal, and neck and shoulder weakness. This combined regional from is able to misdiagnose initially as botulismor diphtheria and less so, myasthenia. So if we were consider variant from of GBS, it is possible for make a correctdiagnosis more easily and treatment without delay.