Room tilt illusion and subclavian steal \u2013 a case report

Kathrine Arntzen,Karl B Alstadhaug

doi:10.1186/s12883-020-01947-2

Kathrine Arntzen, Karl B Alstadhaug

Open Access

https://doi.org/10.1186/s12883-020-01947-2

Copy DOI

Abstract

BackgroundRoom tilt illusion (RTI) is a rare symptom of higher vestibular dysfunction, consisting of a transient vertical rotation of the visual scene in the sagittal or coronal plane, most often 90o or 180o, without any alteration in shape, size and color of objects.Case presentationA 63-year-old woman with a history of hypertension and chronic obstructive pulmonary disease went through an uncomplicated aortobifemoral graft surgery due to aortoiliac occlusive disease. Post-operatively she experienced five episodes, lasting from 10 to 30 min, with RTI; 90o forward rotation of the visual scene in the sagittal plane. Work-up revealed subclavian steal grade 3, and transient ischemia of the central vestibular system of the brainstem was the presumed mechanism.ConclusionThe course of episodic RTIs is often benign, but RTI may represent ischemia in the posterior cerebral circulation. Both stroke and otoneurologic workup are recommended. To our knowledge, this is the first case of RTI associated with subclavian steal reported.

Highlights

Room tilt illusion (RTI) is a rare symptom of higher vestibular dysfunction, consisting of a transient vertical rotation of the visual scene in the sagittal or coronal plane, most often 90o or 180o, without any alteration in shape, size and color of objects.Case presentation: A 63-year-old woman with a history of hypertension and chronic obstructive pulmonary disease went through an uncomplicated aortobifemoral graft surgery due to aortoiliac occlusive disease
The course of episodic RTIs is often benign, but RTI may represent ischemia in the posterior cerebral circulation. Both stroke and otoneurologic workup are recommended. This is the first case of RTI associated with subclavian steal reported
The phenomenon of room tilt illusion (RTI) was first described in a patient thought to suffer from hysteria in 1805 [1]

Summary

Conclusion

The course of episodic RTIs is often benign, but RTI may represent ischemia in the posterior cerebral circulation. Both stroke and otoneurologic workup are recommended. To our knowledge, this is the first case of RTI associated with subclavian steal reported

Background

Discussion and conclusions