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독사교상 후 일측 전정신경염: 발생에는 인과관계가 있는가?

Unilateral Vestibular Neuritis after Snakebite: Is There a Causal Relationship?

Research in Vestibular Science 2020년 19권 4호 p.144 ~ 148
김재명, 박현중, 김신아, 이승한,
소속 상세정보
김재명 ( Kim Jae-Myung ) - Chonnam National University Medical School Chonnam National University Hospital Department of Neurology
박현중 ( Park Hyeon-Joong ) - Chonnam National University Medical School Chonnam National University Hospital Department of Neurology
김신아 ( Kim Shin-A ) - Chonnam National University Medical School Chonnam National University Hospital Department of Neurology
이승한 ( Lee Seung-Han ) - Chonnam National University Medical School Chonnam National University Hospital Department of Neurology

Abstract


Vast majority of triggering factors preceding vestibular neuritis (VN) are unknown, although many cases are associated with viral infection. A 55-year-old woman was bitten by a viper on her right hand, and she was treated with antivenom at the primary clinic. Three days later, acute persistent vertigo was developed. Neuro-otologic examinations revealed spontaneous left-beating nystagmus and abnormal head impulse test in the right side. Taken together with negative result of brain magnetic resonance imaging, she was diagnosed with a right VN. Various neurological complications such as paralysis, optic neuritis, and stroke can occur after snakebite envenoming. In this case, given the time interval between snakebite and development of dizziness, snakebite envenoming might be a possible predisposing factor of VN as a proinflammatory condition rather than a direct cause of VN. Furthermore, the VN of this case was probably caused by late adverse reactions after antivenom administration. Since about 10% of the snake-bitten patients have complained dizziness, detailed neuro-otologic evaluations may lead to a proper understanding of pathomechanism and a correct diagnosis.

키워드

Snake bites; Vestibular neuritis; Acute vestibular syndrome

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