MedRead Journal of Neuroscience and Neurological Disorders

The Brain is a Delightful Part

Rare cause of central vertigo of metabolic origin due to vitamin B1 deficiency: Case Report

Published on: 2020-03-19


This presentation shares an extremely rare case, patient with central acute dizziness of metabolic origin for lack of vitamin B1. A 27-year-old patient hospitalized for severe celiac disease with asthenia, jaundice and deterioration of general condition, presenting a rotary vertigo, tinnitus for 4 days and uncontrollable vomiting. The clinical examination revealed an up-beating nystagmus on primary gaze that increased slightly on lateral gaze, increased markedly on upgaze and decreased significantly in amplitude and frequency on downgaze. At the videonystagmography, occulomotricity test was pathological, the kinetic test was normal except the Eye Fixation Index (EFI) at 0,44. The caloric test was normal.The brain MRI was normal, the blood test of vitamin B1 was decreased.The patient benefited from an intravenous B vitamin therapy with a clear improvement of her symptomatology after 3 weeks of treatment. Vertigo of central origin is a rare cause and often unknown, the management is often difficult.


Videonystagmography; Central vertigo; Thiamine deficiency