Persistent Direction-Fixed Nystagmus Following Canalith Repositioning Maneuver for Horizontal Canal BPPV: A Case of Canalith Jam.
- Author:
Young Soo CHANG
1
;
Jeesun CHOI
;
Won Ho CHUNG
Author Information
1. Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sunkyunkwan University School of Medicine, Seoul, Korea. whchung@skku.edu
- Publication Type:Case Report
- Keywords:
Canalith jam;
Benign paroxysmal positional vertigo;
Repositioning maneuver
- MeSH:
Dizziness;
Head;
Humans;
Middle Aged;
Nystagmus, Pathologic;
Nystagmus, Physiologic;
Vertigo
- From:Clinical and Experimental Otorhinolaryngology
2014;7(2):138-141
- CountryRepublic of Korea
- Language:English
-
Abstract:
The authors report a 64-year-old man who developed persistent direction fixed nystagmus after a canalith repositioning maneuver for horizontal canal benign paroxysmal positional vertigo (HC-BPPV). The patient was initially diagnosed with right HC-BPPV given that the Dix-Hallpike test showed geotropic horizontal nystagmus that was more pronounced on the right side, although the roll test did not show any positional nystagmus. The patient was treated with a canalith repositioning maneuver (Lempert maneuver). The next day, the patient experienced a different character of dizziness, and left-beating spontaneous nystagmus regardless of head position was observed. After a forced prolonged left decubitus and frequent head shaking, his symptoms and nystagmus resolved. This condition, referred to as canalith jam, can be a complication after the repositioning maneuver in patients with BPPV. Atypical positional tests suggest that abnormal canal anatomy could be the underlying cause of canalith jam.
