Abstract
We report here a case of a 55-year-old man who showed the jumbling phenomenon due to thiamine deficiency.This patient complained of disturbances in visual fixation during walking after about 10 days fasting. His serum thiamine level was low but other serum vitamin levels were within the normal ranges. Neuro-otological examination showed bilateral canal paresis, saccadic pursuit and disturbance of the optokinetic responses. After prescribing thiamine, his clinical symptoms recovered gradually and caloric responses, eye tracking and optokinetic responses improved simultaneously. We consider that the jumbling phenomenon in this case was caused by not only a loss of bilateral vestibular function but also by brainstem dysfunction.
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