Review
Clinical Neurology
Joao Lemos, Michael Strupp
Summary: Central positional nystagmus (CPN) can account for up to 12% of patients with positional nystagmus and is often associated with structural lesions in the cerebellum and/or brainstem. Treatment of CPN includes pharmacotherapy and causative treatment for underlying diseases.
JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Sun-Uk Lee, Hyo-Jung Kim, Eek-Sung Lee, Jae-Hwan Choi, Jeong-Yoon Choi, Ji-Soo Kim
Summary: This study analyzed the clinical and neurotologic findings of six patients with isolated unilateral ICP infarction and found that central positional nystagmus (CPN) is a common feature of ICP lesions. The study also suggested that CPN may be attributed to damage of the fibers running from the nodulus/uvula onto the vestibular nucleus via the ICP.
JOURNAL OF NEUROLOGY
(2021)
Article
Clinical Neurology
Alexandra Weckel, Yohann Gallois, Rachel Debs, Bernard Escude, Laurent Tremelet, Fanny Varenne, Damien Biotti, Dominique Chauveau, Fabrice Bonneville
Summary: This article reports a case of a 48-year-old woman with Erdheim-Chester disease (ECD), a rare histiocytic disorder. The patient initially presented with gait instability and central positional nystagmus. Through various imaging tests and a biopsy, the diagnosis of ECD was confirmed.
FRONTIERS IN NEUROLOGY
(2022)
Review
Clinical Neurology
Ana Ines Martins, Andre Jorge, Joao Lemos
Summary: This review evaluates the treatment options for central positional nystagmus (CPN) and highlights the heterogeneity in treatment response. Various therapeutic approaches have been suggested for different etiologies of CPN.
CURRENT TREATMENT OPTIONS IN NEUROLOGY
(2022)
Article
Medicine, General & Internal
Emilio Dominguez-Duran, Lucia Prieto-Sanchez-de-Puerta, Daniel Ivan Martin-Jimenez, Serafin Sanchez-Gomez
Summary: This study found that healthy individuals can experience positional end-point nystagmus during positional testing if they unintentionally look towards the examined ear. The nystagmus has a short latency and lasts as long as the head is maintained in the test position. It can have different directions and senses, but torsional clockwise in left tests and anticlockwise in right tests are the most common. Unlike BPPV, this nystagmus does not appear with the eyes in the straight-ahead position, is asymptomatic, and does not decline in intensity.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Clinical Neurology
Yuexia Wu, Ning Song, Xia Ling, Xiang Li, Yufei Feng, Yue Xing, Ping Gu, Xu Yang
Summary: This study investigated the incidence and characteristics of canal switch (CS) in benign paroxysmal positional vertigo (BPPV), as well as the underlying mechanisms. The results showed that CS in BPPV is uncommon, with AC-BPPV patients being more likely to experience canal switch. The CS-BPPV group had higher intensity and a higher incidence of direction-reversing nystagmus compared to the NCS-BPPV group.
FRONTIERS IN NEUROLOGY
(2022)
Review
Clinical Neurology
Moussa Toudou-Daouda, Cosmin Alecu, Nicolas Chausson, Nana Rahamatou Aminou-Tassiou, Leonard Smadja, Djibril Soumah, Manvel Aghasaryan, Tony Al Tarcha, Didier Smadja
Summary: Isolated cerebellar nodulus infarction (ICNI) and acute peripheral vestibulopathy (APV) share great clinical similarity, but can be differentiated by specific symptoms. Discriminant clinical elements of ICNI include direction-changing gaze-evoked nystagmus, bilateral leaning or falling, and a normal head impulse test.
JOURNAL OF CLINICAL NEUROSCIENCE
(2021)
Article
Clinical Neurology
Yuan Xing Chen, Han Jun Sun, Xue Tao Mu, Chao Jiang, Hui Bing Wang, Qing Hua Zhang, Yuan Yi Qu, Jian Li, Ling Ling Zhou, Long Zhu Zhao, Ning Yu, Qing Sun
Summary: This study analyzed the clinical characteristics of 6 patients with intracranial tumors who only presented with positional vertigo to avoid misdiagnosis. All patients experienced positional vertigo and accompanying nystagmus induced by changes in head position or posture.
FRONTIERS IN NEUROLOGY
(2022)
Article
Clinical Neurology
Jae-Myung Kim, Seung-Han Lee, Hyo-Jung Kim, Ji-Soo Kim
Summary: This article discusses the emerging and controversial syndromes of BPPV, as well as atypical nystagmus based on the involved canal and persistent geotropic positional nystagmus. These topics contribute to a better understanding of the pathomechanisms of BPPV and differentiation from central vertigo and nystagmus.
JOURNAL OF THE NEUROLOGICAL SCIENCES
(2022)
Article
Medicine, General & Internal
Hyung Lee, Hyun Ah Kim
Summary: This study found that approximately 32% of patients with posterior canal benign paroxysmal positional vertigo (PC-BPPV) exhibited head-shaking nystagmus (HSN), predominantly downbeat, with a significant correlation with head-bending nystagmus (HBN). The presence of a torsional component of HSN was also linked to HBN in PC-BPPV.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Clinical Neurology
Michael C. Schubert, Nathaniel Carter, Sheng-fu Larry Lo
Summary: This case study highlights the importance of non-gravity dependent position testing in diagnosing transient downbeat nystagmus with vertigo. Despite delays in surgery due to suicidal ideation, vertigo symptoms were eventually resolved through a C4-5 anterior cervical dissection and fusion.
FRONTIERS IN NEUROLOGY
(2021)
Article
Audiology & Speech-Language Pathology
Chih-Chung Chen, Chen-Yu Wang, Po-Yueh Chen, Mei-Chien Chen, Ting-Yi Lee, Hsun-Hua Lee
Summary: This study retrospectively analyzed a registry of 2425 cases and found that positional vertigo (PV) is the most common self-reported dizziness pattern, with benign paroxysmal positional vertigo (BPPV) and vestibular migraine (VM) being the most common diagnoses. Cases of PV with atypical positional nystagmus (PN) and PV without PN are also common, with the majority being caused by VM. Managing PV without PN can be challenging, and structured patient-oriented questionnaires are helpful for timely diagnosis and adjustment of treatment goals.
Article
Clinical Neurology
Peixia Wu, Xuebing Liu, Qi Dai, Jiaoda Yu, Jieli Zhao, Fangzhou Yu, Yaoqian Liu, Yongbin Gao, Huawei Li, Wenyan Li
Summary: This study designed deep learning models that can accurately detect and classify the subtype of Benign Paroxysmal Positional Vertigo (BPPV), enabling a quick and straightforward diagnosis of BPPV in clinical setting.
JOURNAL OF NEUROLOGY
(2023)
Article
Clinical Neurology
Xiang Li, Lihong Si, Ning Song, Yuexia Wu, Menglu Zhang, Yufei Feng, Xu Yang
Summary: This study analyzed the incidence and characteristics of direction-reversing nystagmus during positional testing in patients with BPPV, as well as the outcomes of canalith repositioning procedure for these patients. The results suggest that the cause of second-phase nystagmus in BPPV patients with direction-reversing nystagmus may be related to the overpowering slow-phase velocity of the first-phase nystagmus.
OTOLOGY & NEUROTOLOGY
(2023)
Article
Emergency Medicine
Jonathan A. Edlow, Kevin Kerber
Summary: Benign paroxysmal positional vertigo (BPPV) is a common condition and an important cause of acute vertigo or dizziness in emergency department patients. However, the current management of BPPV in emergency departments is suboptimal. Efficient management involves bedside testing and positional maneuver treatment.
ACADEMIC EMERGENCY MEDICINE
(2023)