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Recurrent vertigo attacks cured by stenting a basilar artery stenosis

We describe an unusual case with episodes of vertigo, skew diplopia, and tinnitus cured by stenting a proximal basilar artery stenosis. Although successful stenting of basilar artery stenosis has been well described, this case is unusual because of the stereotyped nature and large number (>200) of ischemic attacks.

A 63-year-old man with mild Parkinson disease (PD) and hypertension was referred for evaluation of disabling recurrent episodes of vertigo, tinnitus, and diplopia for 2 years. A typical episode began with left-sided tinnitus, which became bilateral within a few seconds followed by vertigo and skew diplopia about 30 to 40 seconds later. The spells lasted from 1 to 30 minutes and recurred several times a day. Initially he had spells of just skew diplopia but vertigo was present with all spells for the past year. He never experienced any other neurologic symptoms with attacks. During attacks he would typically …