A Seoul National University Bundang Hospital (SNUBH) research team has discovered a new disease that causes acute dizziness. The disease causes acute dizziness due to abnormalities in the vestibular nerve, cerebellum, and brain stem after infection.

Professor Kim Ji-soo

According to the hospital, dizziness is the second leading cause of emergency room visits by patients, while one in two people in the entire population experiences the symptoms at least once during their lifetime.

As dizziness can lead to severe or chronic diseases if not treated promptly, early diagnosis and treatment are essential to blocking it in advance. In many cases, however, it is hard to pinpoint the exact cause of the symptom, even after conducting various tests such as magnetic resonance imaging.

To find out the exact mechanism by which unexplained dizziness develops, the team, led by Professor Kim Ji-soo, tested 369 people with acute neurological abnormalities who showed no explanation despite tests for antiganglioside antibodies (anti-GQ1b).

About one-third of the patients tested positive for the antibody. Notably, 11 percent of the patients who tested positive for the antibody developed acute dizziness without any other symptoms. The patient’s symptoms were also different from that shown for diseases such as Miller Fisher syndrome and Guillain-Barré syndrome, which manifest symptoms such as extraocular muscle paralysis, muscle strength, and paresthesia, confirming the finding of a new disease.

Gangliosides are phospholipids distributed in mammalian neuronal membranes, which act as receptors for cytokines and hormones.

In some patients, antibodies to gangliosides may occur due to autoimmune mechanisms after infection, and such antibodies may cause nerve damage resulting in muscle weakness, paresthesia, and diplopia.

The researchers found that the anti-GQ1b antibody, a type of antiganglioside antibody, attacks not only the cranial nerves responsible for the movement of the extraocular muscles but also the somatic nervous system responsible for the movement and sensations of the limbs, and in some attacks cerebellum and brain stem that control dizziness.

The team said that hospitals could diagnose the new disease with video nystagmus that closely monitors eye movements and antibody tests. The symptoms usually last two to three weeks, but severe ones can be treated with steroid injections or immunoglobulin injections.

“We are very pleased to find the new disease by identifying the pathogenesis of unknown acute dizziness,” Professor Kim said. “The study suggests a way to overcome the acute dizziness of unknown cause.”

The results of the research were published in Neurology.

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