The central compensation of vestibular tonus imbalance due to
unilateral peripheral vestibular lesions has been repeatedly
documented. Little is known, however, about the central
compensation of vestibular tonus imbalance due to central
lesions. Dorsolateral medullary infarctions (Wallenberg’s syndrome)
typically cause a central vestibular tonus imbalance in
the roll plane with deviations of perceived verticality and
ipsiversive body lateropulsion. The course of normalisation of
the tilts of subjective visual vertical (SVV) in 50 patients who
had acute Wallenberg’s syndrome were retrospectively compared
with that in 50 patients with acute vestibular neuritis. The
initial displacement of SVV was 9.8° in Wallenberg’s syndrome
and 7° in vestibular neuritis. The deviation of SVV significantly
decreased over time within days to weeks in both groups. This
finding shows that the time courses of the central compensation
for dorsolateral medullary infarctions and peripheral vestibular
lesions are similar.