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Aim: The aim of the study was to present clinical neuro-otological symptoms in the case of early stage of the fourth ventricle
tumor diagnosed finally on the base of MRI.
Methods: The battery of otoneurological tests was performed to explain the clinical signs described in 1902 by L. Bruns. Tonal
and speech audiometry, tympanometry, supralevel audiological tests (SISI, Carhartt), brain stem auditory evoked responses
(BAEP), electro and videonystagmography (ENG-VNG), craniocorpography (CCG), Freyss� stabilometry, cervical vestibular
evoked myogenic potentials (cVEMP), somatosensory evoked potentials (SEP), visual evoked potentials (VEP) were analyzed.
MRI finished the diagnosis.
Results: The disturbances of visual-oculomotor, vestibular-oculomotor, vestibulo-spinal and other electrophysiological signs
of the brainstem damage were noted. There were: Paresis of the sixth nerve unilaterally, prolonged latency of III-V waves on
brain stem audiological responses (BERA), asymmetry of the fusion limit of optokinetic nystagmus (OPK), bilateral areflexia
of the caloric and kinetic labyrinth reaction, abnormal Unterberger�s test in craniocorpography (CCG) and the presence of
gaze nystagmus.
Conclusion: The study stressed the value of the wide and careful neuro-otological examination in Bruns syndrome. The
electrophysiological diagnosis was finally confirmed by the MRI, showing the tumor (4Ã?Â?2 mm) of fourth ventricle.