ArticleCerebellum (London, England)2018
The Floccular Syndrome: Dynamic Changes in Eye Movements and Vestibulo-ocular Reflex in Isolated Infarction of the Cerebellar Flocculus.
Article in Cerebellum (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 40 citations in OpenAlex.
- Acute cerebellitis presenting predominantly with vestibular symptoms: reversed corrective saccades and frequency-dependent VOR hyperactivity as clues to cerebellar disinhibition.Journal of neurology · 2026Article
- Neurotologic Findings of Idiopathic Acute Unilateral Audiovestibulopathy.European journal of neurology · 2025Article
- Cerebellar Hemorrhage Masquerading as Unilateral Vestibulopathy: A Case Report.Case reports in neurological medicine · 2025Article
- Dorsolateral pontine lesions produce distinct ocular motor abnormalities with anatomical correlations.European journal of neurology · 2025Article
- Tbx1 haploinsufficiency leads to local skull deformity, paraflocculus and flocculus dysplasia, and motor-learning deficit in 22q11.2 deletion syndrome.Nature communications · 2024Article
- Video head impulse test in stroke: a review of published studies.Frontiers in neurology · 2024Review
- Consensus Paper: Ataxic Gait.Cerebellum (London, England) · 2023Article
- Video head impulse testing in patients with isolated (hemi)nodular infarction.Frontiers in neurology · 2023Article
- A review of pursuit and saccadic eye movements and their utility in stroke.Frontiers in stroke · 2023Review
- Pseudo-reversed catch-up saccades during head impulses: a new cerebellar sign.Journal of neurology · 2022Article
- Head-impulse tests aid in differentiation of multiple system atrophy from Parkinson's disease.Journal of neurology · 2022Article
- Vestibular impairments in episodic ataxia type 2.Journal of neurology · 2022Article
- Positive horizontal-canal head impulse test is not a benign sign for acute vestibular syndrome with hearing loss.Frontiers in neurology · 2022Article
- Vascular vertigo and dizziness: Diagnostic criteria.Journal of vestibular research : equilibrium & orientation · 2022Article
- The spectrum of acute vestibular neuropathy through modern vestibular testing: A descriptive analysis.Clinical neurophysiology practice · 2021Article
- Evolution of the vestibular function during head impulses in spinocerebellar ataxia type 6.Journal of neurology · 2020Article
- Eye Movement Disorders and the Cerebellum.Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society · 2019Review
- Isolated tonsilar infarction presenting with positional vertigo and nystagmus.Journal of neurology · 2019Article
- Vascular vertigo: updates.Journal of neurology · 2019Review
- Use of HINTS in the acute vestibular syndrome. An Overview.Stroke and vascular neurology · 2018Review
Corrections and comments
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Authors and funding
4 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The cerebellar flocculus is a critical structure involved in the control of eye movements. Both static and dynamic abnormalities of the vestibulo-ocular reflex (VOR) have been described in animals with experimental lesions of the flocculus/paraflocculus complex. In humans, lesions restricted to the flocculus are rare so they can become an exceptional model to contrast with the clinical features in experimental animals or in patients with more generalized cerebellar diseases. Here, we examined a 67-year-old patient with an acute vestibular syndrome due to an isolated infarct of the right flocculus. We evaluated him multiple times over 6 months-to follow the changes in eye movements and vestibular function-with caloric testing, video-oculography and head-impulse testing, and the anatomical changes on imaging. Acutely, he had an ipsilateral-beating spontaneous nystagmus, bilateral gaze-evoked nystagmus, borderline impaired smooth pursuit, and a complete contraversive ocular tilt reaction. The VOR gain was reduced for head impulses directed contralateral to the lesion, and there was also an ipsilesional caloric weakness. All abnormalities progressively improved at follow-up visits but with a considerable reduction in volume of the affected flocculus on imaging. The vestibular and ocular motor findings, qualitatively similar to a previously reported patient, further clarify the "acute floccular syndrome" in humans. We also add new information about the pattern of recovery from such a lesion with corresponding changes in the size of the affected flocculus on imaging.
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