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Vertigo and Parinaud's syndrome as presentation of Churg–Strauss syndrome

Department of Otolaryngology, Fundación Hospital Alcorcón, Madrid, Spain; Unidad ORL, Fundación. 28922 Madrid, Spain,gplaza{at}fhalcorcon.es;gmayor{at}ctv.es

J Yangüela

Department of Ophthalmology, Fundación Hospital Alcorcón, Madrid, Spain

J López-Lafuente

Department of Neuroradiology, Fundación Hospital Alcorcón, Madrid, Spain

M J Linares

Department of Neumology, Fundación Hospital Alcorcón, Madrid, Spain

Intracranial complications are rare in Churg–Strauss syndrome (CSS). Cerebral infarctions are the most common intracranial presentation, usually after the clinical diagnosis of CSS had been established. We present a case of vertigo and Parinaud's syndrome as presentation of CSS in an asthmatic patient. Clinical examination revealed upward gaze limitation and bilateral midriasis. A cranial computed tomography scan showed a small round hypoattenuating lesion located in the right thalamic–mesencephalic region, which was later confirmed by magnetic resonance imaging. There was eosinophilia of more than 50%, and p-ANCA were positive. After steroid treatment was started, vertigo and diplopia resolved, and eosinophilia was reduced. After 24 months follow-up, the patient remains stable, with negative p-ANCA, taking 20 mg prednisone daily. Further magnetic resonance exams have shown findings that were similar to those of previous studies. This case shows how vertigo and transient diplopia may be the first symptoms of neurological complications in patients with CSS. Lupus (2001) 10, 653–655.

Key Words: vertigo–nystagmus • Churg–Strauss • MR imaging

Lupus, Vol. 10, No. 9, 653-655 (2001)
DOI: 10.1191/096120301682430267


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