Top

Journal of Neurology

Published in:

01-10-2019 | Benign Paroxysmal Positional Vertigo | Original Communication

Characteristics of positional nystagmus in patients with horizontal canal canalolithiasis or cupulopathy

Authors: Hui Wang, Qingxiu Yao, Zhuangzhuang Li, Dongzhen Yu, Haibo Shi

Published in: Journal of Neurology | Issue 10/2019

Abstract

Objectives

Positional nystagmus can be related to various kinds of disorders. The current study aims to compare the direction-changing horizontal positional nystagmus (DCPN) characteristics in horizontal canal canalolithiasis (HC-canalolithiasis), heavy cupula of the horizontal canal (HC-Hcu), and light cupula of the horizontal canal (HC-Lcu), especially the temporal patterns of positional nystagmus in three disorders.

Methods

52 patients (22 males, 30 females; mean age, 49.6 years) presenting with geotropic or apogeotropic DCPN were enrolled, and they were divided into HC-canalolithiasis, HC-Hcu, or HC-Lcu groups according their nystagmus characteristics. We compared their latency, time constant, peak slow-phase velocity (SPV), time to reach peak SPV intensity (T_peak), and time to decay to half-peak intensity (T_1/2peak).

Results

The time to reach peak SPV did not differ significantly between the HC-Hcu (23.1 ± 8.6 s) and HC-Lcu (24.4 ± 9.9 s) groups (p = 0.733), but was significantly longer than that of the HC-canalolithiasis group (5.4 ± 3.5 s; p ≤ 0.001). The peak intensity did not differ among the canalolithiasis (36.4 ± 20.6º/s), HC-Hcu (30.1 ± 23.6º/s), and HC-Lcu (21.4 ± 12.7º/s) groups (p = 0.133). The onset latency also had no statistical difference among three groups (p = 0.200). The nystagmus patterns of HC-Lcu and HC-Hcu groups were similar, including latency, peak SPV intensity, T_peak, T_1/2peak, and SPV in 20 s, 40 s, 60 s, 80 s.

Conclusions

The nystagmus characteristics of HC-Hcu and HC-Lcu are similar, except for the fact that movement was in opposite directions, suggesting that HC-Hcu and HC-Lcu may result from a similar pathophysiological mechanism (cupulopathy) differing from that underlying canalolithiasis.

von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, Neuhauser H (2007) Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry 78(7):710–715. https://doi.org/10.1136/jnnp.2006.100420 CrossRef

von Brevern M, Bertholon P, Brandt T, Fife T, Imai T, Nuti D, Newman-Toker D (2015) Benign paroxysmal positional vertigo: Diagnostic criteria. Journal vestib Res 25(3–4):105–117. https://doi.org/10.3233/ves-150553 CrossRef

Honrubia V, Baloh RW, Harris MR, Jacobson KM (1999) Paroxysmal positional vertigo syndrome. Am J Otol 20(4):465–470PubMed

Moon SY, Kim JS, Kim BK, Kim JI, Lee H, Son SI, Kim KS, Rhee CK, Han GC, Lee WS (2006) Clinical characteristics of benign paroxysmal positional vertigo in Korea: a multicenter study. J Korean Med Sci 21(3):539–543. https://doi.org/10.3346/jkms.2006.21.3.539 CrossRefPubMedPubMedCentral

Obrist D, Hegemann S, Kronenberg D, Hauselmann O, Rosgen T (2010) In vitro model of a semicircular canal: design and validation of the model and its use for the study of canalithiasis. J Biomech 43(6):1208–1214. https://doi.org/10.1016/j.jbiomech.2009.11.027 CrossRefPubMed

Daniele NTY (2010) Vertigo and Imbalance: clinical neurophysiology of the vestibular system. Handbook of clinical neurophysiology. Elsevier, Oxford, pp 353–370

Hiruma K, Numata T (2004) Positional nystagmus showing neutral points. ORL J Otorhinolaryngol Relat Spec 66(1):46–50. https://doi.org/10.1159/000077234 CrossRefPubMed

Hiruma K, Numata T, Mitsuhashi T, Tomemori T, Watanabe R, Okamoto Y (2011) Two types of direction-changing positional nystagmus with neutral points. Auris Nasus Larynx 38(1):46–51. https://doi.org/10.1016/j.anl.2010.07.004 CrossRefPubMed

Kim CH, Kim MB, Ban JH (2014) Persistent geotropic direction-changing positional nystagmus with a null plane: the light cupula. Laryngoscope 124(1):E15–19. https://doi.org/10.1002/lary.24048 CrossRefPubMed

10.

Imai T, Matsuda K, Takeda N, Uno A, Kitahara T, Horii A, Nishiike S, Inohara H (2015) Light cupula: the pathophysiological basis of persistent geotropic positional nystagmus. BMJ Open 5(1):e006607. https://doi.org/10.1136/bmjopen-2014-006607 CrossRefPubMedPubMedCentral

11.

Wang H, Li XY, Yao QX, Yu DZ (2018) Nystagmus characteristics of the horizontal semicircular canal light cupula Lin chuang er bi yan hou tou jing wai ke za zhi. J Clin Otorhinolaryngol Head Neck Surg 32(17):1332–1334. https://doi.org/10.13201/j.issn.1001-1781.2018.17.009 CrossRef

12.

Seo T, Shiraishi K, Kobayashi T, Mutsukazu K, Doi K (2016) Clinical course of persistent geotropic direction-changing positional nystagmus with neutral position-light cupula. Acta Otolaryngol 136(1):34–37. doi:10.3109/00016489.2015.1079926.CrossRef

13.

Ichijo H (2016) Neutral position of persistent direction-changing positional nystagmus. Eur Arch Oto-Rhino-Laryngol 273(2):311–316. https://doi.org/10.1007/s00405-014-3487-3 CrossRef

14.

Ban JH, Kim MB, Hong SM (2016) Immediate and short-term therapeutic results between direction-changing positional nystagmus with short- and long-duration groups. Ear Hear 37(2):243–246. https://doi.org/10.1097/aud.0000000000000232 CrossRefPubMed

15.

Boumans LJ, Rodenburg M, Maas AJ (1983) Response of the human vestibulo-ocular reflex system to constant angular acceleration. I. Theoretical study. ORL J Oto-Rhino-Laryngol 45(3):117–129. https://doi.org/10.1159/000275635 CrossRef

16.

Boumans LJ, Rodenburg M, Maas AJ (1983) Response of the human vestibulo-ocular reflex system to constant angular acceleration II. Experimental investigation. ORL J Oto Rhino-Laryngol 45(3):130–142. https://doi.org/10.1159/000275636 CrossRef

17.

Baloh RW, Yue Q, Jacobson KM, Honrubia V (1995) Persistent direction-changing positional nystagmus: another variant of benign positional nystagmus? Neurology 45(7):1297–1301CrossRef

18.

Baloh RW, Honrubia V, Yee RD, Hess K (1984) Changes in the human vestibulo-ocular reflex after loss of peripheral sensitivity. Ann Neurol 16(2):222–228. https://doi.org/10.1002/ana.410160209 CrossRefPubMed

19.

Sills AW, Honrubia V, Baloh RW (1978) Is the adaptation model a valid description of the vestibulo-ocular reflex? Biol Cybern 30(4):209–220CrossRef

Title: Characteristics of positional nystagmus in patients with horizontal canal canalolithiasis or cupulopathy
Authors: Hui Wang
Qingxiu Yao
Zhuangzhuang Li
Dongzhen Yu
Haibo Shi
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Keywords: Benign Paroxysmal Positional Vertigo
Nystagmus
Published in: Journal of Neurology / Issue 10/2019
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-019-09435-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Characteristics of positional nystagmus in patients with horizontal canal canalolithiasis or cupulopathy

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 10/2019

Screening for cognitive impairment among patients with neuromyelitis optica using touchscreen cognitive testing in routine clinical care

Diplopia in Parkinson’s disease: visual illusion or oculomotor impairment?

Comparative efficacy and safety of therapy for the behavioral and psychological symptoms of dementia: a systemic review and Bayesian network meta-analysis

Relapses and obstetric outcomes in women with multiple sclerosis planning pregnancy

Outcomes after fingolimod to alemtuzumab treatment shift in relapsing–remitting MS patients: a multicentre cohort study

Influence of controlled encoding and retrieval facilitation on memory performance of patients with subcortical ischemic vascular dementia and Alzheimer’s disease