Ethiodized-oil

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Inferior vestibular nerve displacement affecting vestibulo-ocular reflex: case report An 83-year-old man experienced effect on vestibulo-ocular reflex secondary to inferior vestibular nerve displacement after undergoing myelography with contrasting agent ethiodized oil. The man presented with a 3-month history of positional paroxysmal vertigo and progressive imbalance. Otoneurological examination was normal. A 3D video headimpulse test demonstrated a low gain of the vestibulo-ocular reflex in the posterior canals. Brain MRI revealed mild cerebral atrophy and cerebral white matter with moderate microvascular changes. MRI of the inner ear showed small dots in the internal auditory canals and large droplets in the basal CSF spaces. These appeared highly attenuated on CT scan and were associated with a myelography, which was carried out previously with a liposoluble contrasting agent ethiodized oil [Lipiodol; route and exact amount not stated]. The small dots were located between the inferior vestibular nerves and posterior wall of the internal auditory canals, leading to anterior displacement of the inferior vestibular nerves. Linear enhancement of the inferior vestibular nerve was noted on the left side after gadolinium injection, without increase in thickness. Additionally, the right inferior vestibular nerve showed a punctate contrast enhancement [time to reaction onset and event outcome not stated]. Author comment: "To the best of our knowledge, this is the first report of peripheral vestibular neurotoxicity related to delayed effects of myelographic liposoluble contrast agent." Sousa RF, et al. Bilateral Inferior Vestibular Nerve Lesion a Late Neurotoxic Effect of Liposoluble Myelographic Contrast Agent : Case Report with Imaging and Electrophysiological Confirmation. Clinical Neuroradiology 29: 163-165, No. 1, Mar 2019. Available from: URL: http://doi.org/10.1007/s00062-018-0688-y 803432831 Portugal

0114-9954/19/1778-0001/$14.95 Adis © 2019 Springer Nature Switzerland AG. All rights reserved

Reactions 9 Nov 2019 No. 1778

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