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Central nystagmus and alterations in vestibular tests due to an inadvertent gentamicin administration into spinal space: A CARE case report

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dc.contributor.authorBreinbauer, Hayo
dc.contributor.authorEyzaguirre, M.
dc.contributor.authorHerrero, D.
dc.contributor.authorDelano, P.
dc.date.accessioned2023-11-30T19:54:23Z
dc.date.available2023-11-30T19:54:23Z
dc.date.issued2022
dc.description.abstractIntroduction Gentamicin has a well-known potential for damaging the peripheral vestibular organs. However, it is considered to be innocuous to the CNS as it crosses the blood-brain barrier poorly. Here, we describe central neuro-otological abnormalities developed by a patient after deployment of gentamicin into his spinal space. Case summary. A 61-year-old male unintentionally received gentamicin during spinal locoregional anesthesia for a urological procedure. During the first 48 hours the patient presented upper extremity dysmetria, dysarthria, and bilateral abducens nerve paralysis from which he recovered completely. He remained asymptomatic from day 3 to 10 after the incident. On day 11 he presented an acute vestibular syndrome. Severe bilateral vestibulopathy was confirmed by means of video head impulse testing. From day 14 onwards, he presented a persistent horizontal left-beating nystagmus, showing no variation or signs of compensation after 14 months, not responding to intensive vestibular rehabilitation or vestibular suppressant drugs. During follow-up, intercurrent gaze-evoked/direction-changing nystagmus has been recorded in various opportunities. Discussion We interpreted these findings as signs of both severe peripheral bilateral vestibulopathy and cerebellar and/or midbrain late-onset neurotoxicity, which can be explained by the intrinsic neurotoxic capability of high doses of gentamicin in the CNS.
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dc.identifier.citationBreinbauer HA, Eyzaguirre M, Herrero D, Delano PH. Central nystagmus and alterations in vestibular tests due to an inadvertent gentamicin administration into spinal space: A CARE case report. Eur Ann Otorhinolaryngol Head Neck Dis. 2022 Aug;139(4):226-229. doi: 10.1016/j.anorl.2021.07.010v
dc.identifier.doihttps://doi.org/10.1016/j.anorl.2021.07.010
dc.identifier.urihttps://repositorio.udd.cl/handle/11447/8077
dc.language.isoen
dc.subjectAdverse effects
dc.subjectCentral vertigo
dc.subjectGentamicin
dc.subjectNeurotoxicity
dc.subjectOtotoxicity
dc.titleCentral nystagmus and alterations in vestibular tests due to an inadvertent gentamicin administration into spinal space: A CARE case report
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceEuropean Annals of Otorhinolaryngology, Head and Neck Diseases
dspace.entity.typePublication

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