Three-dimensional videonystagmography characteristics in patients with benign paroxysmal positional vertigo
10.12025/j.issn.1008-6358.2025.20250222
- VernacularTitle:良性阵发性位置性眩晕患者三维视频眼震图特征分析
- Author:
Yujin ZHENG
1
,
2
;
Keguang CHEN
2
;
Kanglun JIANG
2
;
Feng XU
2
;
Ying QI
2
;
Xinsheng HUANG
2
;
Huaili JIANG
2
Author Information
1. Department of Otolaryngology, Zhongshan Hospital (Xiamen Branch), Fudan University, Xiamen 361015, Fujian, China
2. Department of Otolaryngology Head and Neck Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
- Publication Type:Monographicreport:Multi-disciplinarydiagnosisandtreatmentofvertigo
- Keywords:
three-dimensional videonystagmography;
benign paroxysmal positional vertigo;
posterior semicircular canal;
horizontal semicircular canal
- From:
Chinese Journal of Clinical Medicine
2025;32(2):177-182
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the characteristics of nystagmus during the Dix-Hallpike and Roll tests in patients with benign paroxysmal positional vertigo (BPPV) using three-dimensional videonystagmography (3D-VNG), in order to to optimize diagnostic and therapeutic strategies of BPPV. Methods A retrospective analysis was conducted on 68 patients with posterior semicircular canal (PSC)-BPPV and 26 patients with horizontal semicircular canal (HSC)-BPPV. Nystagmus data obtained from 3D-VNG were reviewed for all patients, with a focus on the eye movement components during the Dix-Hallpike test in PSC-BPPV patients and the Roll test in HSC-BPPV patients. The direction and reversal rates of the vertical, horizontal, and torsional components were recorded and analyzed. Results All PSC-BPPV patients exhibited highly consistent three-dimensional nystagmus characteristics during the Dix-Hallpike test: vertical nystagmus was uniformly upward, torsional nystagmus was predominantly clockwise in left-side BPPV patients (17/23) and counterclockwise in right-side BPPV patients (44/45), while the horizontal component was mostly directed contralaterally (50/68); upon transitioning from the head-hanging to the sit-up position, vertical nystagmus components in all patients reversed, and torsional and horizontal nystagmus components reversed in approximately 50.0% or more patients. Among HSC-BPPV patients, right-side BPPV patients all showed right-beating (geotropic) horizontal nystagmus with predominantly upward vertical component (16/19), while most left-side BPPV patients showed left-beating horizontal nystagmus (6/7) with predominantly downward vertical component (6/7). During head rotation toward the healthy side, most (25/26) HSC-BPPV patients exhibited a reversal in the horizontal nystagmus direction, reduced intensity compared to the affected side, with a reversal in vertical components in 3 patients, and atypical torsional components. Conclusions 3D-VNG could precisely quantitative analyze three-dimensional features of nystagmus in BPPV patients, improve diagnostic accuracy in canal and side localization, particularly in PSC-BPPV patients.
