A case of Costen's syndrome with chewing-induced vertigo

DOI 24 References
  • Sekine Kazunori
    Department of Otolaryngology, University of Tokushima School of Medicine
  • Imai Takao
    Department of Otolaryngology and Sensory Organ Surgery, Osaka University Graduate School of Medicine
  • Tachibana Fumitoshi
    Tachibana ENT Clinic
  • Matuda Kazunori
    Department of Otolaryngology, University of Tokushima School of Medicine
  • Sato Go
    Department of Otolaryngology, Yashima General Hospital
  • Takeda Noriaki
    Department of Otolaryngology, University of Tokushima School of Medicine

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Other Title
  • 咀嚼によりめまいが誘発されたＣｏｓｔｅｎ症候群症例

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Abstract

We report a case of Costen's syndrome that showed chewing-induced nystagmus and vertigo. A 31-year-old woman visited our hospital complaining of chewing-induced vertigo 5 days after dental therapy. During chewing a stick of gum, she complained of vertigo and showed nystagmus beating to the right, the direction of which changed to the left thereafter. No spontaneous and positional nystagmus or any abnormalities in the neurological examination could, however, be found. The chewing-induced nystagmus and vertigo gradually disappeared within 2 weeks. Costen's syndrome is associated with various symptoms due to temporomandibular dysfunction. In the case, it is suggested that malinterdigitation after dental therapy caused temporomandibular dysfunction, resulting in the chewing-induced nystagmus, therefore, Costen's syndrome was diagnosed.<br>Eustachian tube hypothesis, Tensor tympani hypothesis and otomandibular ligament hypothesis that accounted for temporomandibular dysfunction-induced aural symptoms in patient with Costen's syndrome had been proposed, but recently were withdrew. On the other hand, it is reported that reciprocal connections between trigeminal and vestibular nuclei. The trigeminal somatosensory input associated with temporomandibular dysfunction after dental therapy may cause chewing-induced nystagmus via the trigemino-vestibular connection in the brainstem in the case.

Journal

  • Equilibrium Research

    Equilibrium Research 69 (1), 47-51, 2010

    Japan Society for Equilibrium Research

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