case_images: PMC11835124_01
case_images: Bithermal caloric test at August 23, 2022. After the right ear was injected with cold air and hot air, the sum of slow phase velocity was 10 /s, while that of the left ear was 5 /s, and the canal paralysis value is 33%, which was >25%, indicating that the low-frequency response of the left horizontal semicircular canal was reduced.
case_images: medi-104-e41558-g001.jpg
case_images: PMC11835124_01_medi-104-e41558-g001.jpg
case_images: F1
case_images: A bithermal caloric test of vestibular function revealed a decreased low-frequency response in the right horizontal semicircular canal (Fig. 1).
case_images: Cerebral MRI in FLAIR image at admission. (A) showed hyperintense lesion in the temporal regions (arrowheads). (B) showed hyperintense lesion in the bilateral insular regions (arrowheads). FLAIR = fluid attenuated inversion recovery, MRI = magnetic resonance imaging.
case_images: medi-104-e41558-g002.jpg
case_images: PMC11835124_01_medi-104-e41558-g002.jpg
case_images: F2
case_images: Cerebral MRI showed hyperintense lesions in the bilateral insular and temporal regions on T2-weighted images and hypointense lesions on T1 images, accompanied by hyperintensity on fluid attenuated inversion recovery (FLAIR) images (Fig. 2).
case_images: Cerebral MRI in FLAIR image at discharge and 1 yr after discharge. (A and B) showed that hyperintense lesion in the bilateral insular and temporal lobe lesions had no significant changes compared with Fig. 2 (arrowheads). (C and D) showed normal brain tissue 1 yr after discharge. FLAIR = fluid attenuated inversion recovery, MRI = magnetic resonance imaging.
case_images: medi-104-e41558-g003.jpg
case_images: PMC11835124_01_medi-104-e41558-g003.jpg
case_images: F3
case_images: However, there was no significant change in his brain MRI compared to the time of symptom onset, and it did not normalize until 1 year after his discharge from the hospital (Fig. 3).