scholarly journals Head-Shaking Nystagmus in Posterior Canal Benign Paroxysmal Positional Vertigo with Canalolithiasis

2021 ◽  
Vol 10 (5) ◽  
pp. 916
Author(s):  
Hyung Lee ◽  
Hyun Ah Kim
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Velocity Storage ◽  
Downbeat Nystagmus ◽  
Head Turning ◽  
Frequency Pattern ◽  
Posterior Canal ◽  
Positional Vertigo ◽  
Torsional Component ◽  
Lying Down ◽  
Paroxysmal Positional Vertigo

Background: There have been several studies about head-shaking nystagmus (HSN) in posterior canal benign paroxysmal positional vertigo (PC-BPPV). The purpose of the study was to determine the characteristics of HSN and its relationship with head-bending nystagmus (HBN) and lying-down nystagmus (LDN) in PC-BPPV and to suggest a possible pathomechanism of HSN based on these findings. Methods: During the study period, 992 patients with BPPV were initially enrolled. After excluding horizontal or anterior canal BPPV, multiple canals involvement, secondary causes of BPPV, identifiable central nervous system (CNS) disorders, unidentifiable lesion side, or poor cooperation, 240 patients with unilateral PC-BPPV were enrolled. We assessed the frequency, pattern of HSN, and correlation with other induced nystagmus after positional maneuvers such as head bending, lying down, head-turning, and Dix-Hallpike test. Results: Approximately 32% of patients with PC-BPPV showed HSN. Among patients with HSN, approximately 61% of patients showed predominantly downbeat nystagmus, and two-third of them had a torsional component. The torsional component was mostly directed to the contralesional side. Horizontal nystagmus (36%) and upbeat nystagmus (3%) were also observed after head-shaking in PC-BPPV. The presence of HSN was significantly correlated with that of HBN in PC-BPPV (p = 0.00). The presence of a torsional component of HSN was also significantly correlated with that of HBN in PC- BPPV (p = 0.00). Discussion: Perverted HSN, a typical sign of central vestibulopathy, is common in posterior canal BPPV and related to HBN. For generating HSN in PC-BPPV, the otolithic movements related to the endolymph dynamics seem to be more important than the velocity storage mechanism.

Prolonged Positional Downbeat Nystagmus in Benign Paroxysmal Positional Vertigo: A Case Report and Literature Review

2021 ◽  
pp. 1-6
Author(s):  
Hyun-Jin Lee ◽  
Seong Ki Ahn ◽  
Chae Dong Yim ◽  
Seong Dong Kim ◽  
Dong Gu Hur
Keyword(s):  
Medical Records ◽  
Unusual Case ◽  
Benign Paroxysmal Positional Vertigo ◽  
Clinical Manifestations ◽  
Careful Consideration ◽  
Downbeat Nystagmus ◽  
Positional Vertigo ◽  
Torsional Component ◽  
Anterior Canal ◽  
Paroxysmal Positional Vertigo

Purpose This study aimed to report an unusual case of benign paroxysmal positional vertigo (BPPV), who showed prolonged positional downbeat nystagmus without latency and was diagnosed with cupulolithiasis of the anterior canal (AC). We compared this case with one of typical AC-BPPV, and possible mechanisms underlying the atypical characteristics were discussed. Method Two patients diagnosed with AC-BPPV were reported. Positional testing using video-oculography goggles was performed, and outcomes were measured via medical records and analysis of videos of the nystagmus. Results Downbeat nystagmus was observed in the contralateral Dix–Hallpike test in both cases. The torsional component was subtle or absent, but motion was induced toward the affected ear. The two cases differed in latency and duration of vertigo, as well as habituation. The patient with atypical nystagmus showed little or no latency and longer duration. Moreover, there was no habituation on repeated tests. The nystagmus showed several differences from that of typical AC-BPPV. Conclusions Based on our case, AC-BPPV may induce various unusual clinical manifestations of nystagmus. Accurate diagnosis requires careful consideration of the patient's symptoms and the characteristics of the nystagmus. Supplemental Material https://doi.org/10.23641/asha.14265356

Vestibular evoked myogenic potentials in idiopathic posterior canal benign paroxysmal positional vertigo

2013 ◽  
Vol 11 (4) ◽  
pp. 176-181 ◽  
Author(s):  
Hossam Sanyelbhaa Talaat ◽  
Mohamed Akram Metwaly ◽  
Ahmed Hafez Khafagy ◽  
Hatem Ragaa Abdelraouf ◽  
Hoda Abu Moussa Isak
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Vestibular Evoked Myogenic Potentials ◽  
Posterior Canal ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

scholarly journals Persistent Upbeat Positional Nystagmus in a Patient with Bilateral Posterior Canal Benign Paroxysmal Positional Vertigo

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Akihide Ichimura ◽  
Shigeto Itani
Keyword(s):  
Supine Position ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Downbeat Nystagmus ◽  
Positional Vertigo ◽  
Head Roll ◽  
The Right ◽  
Upbeat Nystagmus ◽  
Torsional Nystagmus ◽  
Paroxysmal Positional Vertigo

Here, we report a patient with persistent positional upbeat nystagmus in a straight supine position with no evident abnormal central nervous system findings. A 43-year-old woman with rotatory positional vertigo and nausea visited our clinic 7 days after the onset. Initially, we observed persistent upbeat nystagmus in straight supine position with a latency of 2 s during the supine head roll test. However, an upbeat nystagmus disappeared on turning from straight to the left ear-down supine position, and while turning from the left to right ear-down position, an induced slight torsional nystagmus towards the right for >22 s was observed. In the Dix–Hallpike test, the left head-hanging position provoked torsional nystagmus towards the right for 50 s. In prone seated position, downbeat nystagmus with torsional component towards the left was observed for 45 s. Neurological examination and brain computed tomography revealed no abnormal findings. We speculated that persistent positional upbeat nystagmus in this patient was the result of canalolithiasis of benign paroxysmal positional vertigo of bilateral posterior semicircular canals.

scholarly journals Effect of the Canalith Repositioning Procedure on Benign Paroxysmal Positional Vertigo. Posterior Canal Type.

1998 ◽  
Vol 91 (4) ◽  
pp. 341-345
Author(s):  
Ken HAYASHI ◽  
Naoki HAYASHI ◽  
Mamoru SUZUKI ◽  
Tohru TANIGAWA ◽  
Muneo TAKAMOTO ◽  
...  
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Posterior Canal ◽  
Positional Vertigo ◽  
Canalith Repositioning Procedure ◽  
Paroxysmal Positional Vertigo
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