[Room tilt illusion: a chief complaint need to be alert in otology clinic].

This study aims to investigated the clinical significance of room tilt illusion（RTI） in screening for central vertigo in otology clinic. A retrospective study of 8 RTI cases out of 656 patients with dizziness and/or vertigo. The characteristics of the symptoms, signs, physical examination, and other examinations of RTI patients were analyzed. ①Patients with RTI complaints accounted for 1.2% of all patients with dizziness and/or vertigo in the same period. Of all 8 patients, 2 were with acute vestibular syndrome, 5 were with episodic vestibular syndrome, and one had no dizziness and/or vertigo attack. ②Two was diagnosed with acute cerebellar infarction, and 3 was diagnosed with posterior circulation transient ischemic attacks, 2 were diagnosed with definite vestibular migraine, and one was unable to identify the cause. ③All 8 patients had a sensation of environment tilting, which was episodic（single or repeated）, transient（seconds to minutes）, in the coronal plane, and with tilt angle 30-180°. ④Seven patients had dizziness and/or vertigo for minutes to hours after a transient RTI, and one patient had no other symptoms after RTI. ⑤All patients had no decrease in vHIT gain, 6 patients had abnormal oculomotor function, and one patient had mild horizontal semicircular canal paresis. Patients with RTI complaints mainly had central dizziness and vertigo diseases, and once are found in otology clinic, should be alert to the possibility of suffering from central diseases.