Abstract
Down-beating positional nystagmus is typically associated with central nervous system disease. Anterior canal benign paroxysmal positional vertigo (AC-BPPV) can mimic down-beating positional nystagmus of central origin, particularly when it is bilateral. Factors that increase the probability of bilateral AC-BPPV include a history of bilateral multicanal BPPV, transient down-beating and torsional nystagmus that follows the plane of the provoked canal, and the absence of co-occurring neurologic signs and symptoms of central nervous system dysfunction. With neurologic clearance for canalith repositioning, exploration for AC-BPPV and canalith repositioning trials may alleviate symptoms even when the nystagmus does not appear to fatigue. In the case presented, the use of a side-lying maneuver with the nose down to provoke AC-BPPV symptoms and the use of a reversed Epley to clear AC-BPPV symptoms are highlighted. This approach is helpful when the diagnosis is unclear and neck hyperextension is to be avoided.
Original language | English (US) |
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Pages (from-to) | 257-266 |
Number of pages | 10 |
Journal | Journal of the American Academy of Audiology |
Volume | 19 |
Issue number | 3 |
DOIs | |
State | Published - Mar 2008 |
Keywords
- Anterior semicircular canal
- Benign paroxysmal positional vertigo
- Canalithiasis
- Down-beating nystagmus
- Horizontal semicircular canal
- Posterior semicircular canal
ASJC Scopus subject areas
- Speech and Hearing