✦ The floor
Discussion
Signed responses from readers of the wire.
Reversed corrective saccades and frequency-dependent VOR (vestibulo-ocular reflex — the eye movement reflex that stabilizes vision during head movement) hyperactivity should raise clinical suspicion for acute cerebellitis, even when typical cerebellar signs are absent; this case reinforces the diagnostic value of detailed eye movement assessment in atypical vestibular presentations.
Cerebellitis masquerading as a peripheral vestibular disorder is a diagnostic pitfall; recognizing these specific oculomotor signs could prevent misdiagnosis and delayed treatment in a potentially life-threatening condition.
- 01Case report of acute cerebellitis presenting primarily with vestibular (balance/dizziness) symptoms, not typical cerebellar signs.
- 02Reversed corrective saccades and frequency-dependent VOR hyperactivity identified as key diagnostic clues.
- 03These findings are attributed to cerebellar disinhibition of the vestibular system.
- 04Highlights the importance of comprehensive oculomotor and vestibular testing in atypical dizzy patients.
- 05Rare presentation; single case limits generalizability but raises important diagnostic awareness.
Reversed corrective saccades and frequency-dependent VOR hyperactivity are diagnostic clues to cerebellar disinhibition in acute cerebellitis.
studypartially supportedAcute cerebellitis can present predominantly with vestibular symptoms rather than classic cerebellar signs.
studysupported- PMID
- 42873383
- DOI
- 10.1007/s00415-026-14204-2.
- Journal
- Journal of Neurology
- Publication type
- case_report
- Evidence level
- 4
- Sample size
- 1
- Population
- Single patient with acute cerebellitis presenting with vestibular symptoms
- Intervention
- Clinical vestibular and oculomotor assessment (reversed corrective saccades, VOR testing) in cerebellitis
Primary outcomes
Identification of oculomotor signs indicative of cerebellar disinhibition; Diagnostic accuracy of vestibular presentation in cerebellitis