Pseudo-Spontaneous Nystagmus and Head-Shaking Nystagmus in Horizontal Canal Benign Paroxysmal Positional Vertigo
10.21790/rvs.2017.16.4.129
- Author:
Yong Gook SHIN
1
;
Ja Won GU
;
Jin Wook KANG
;
Mee Hyun SONG
;
Dae Bo SHIM
Author Information
1. Department of Otorhinolaryngology, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea. lovend77@gmail.com
- Publication Type:Original Article
- Keywords:
Benign paroxysmal positional vertigo;
Horizontal canal;
Spontaneous nystagmus;
Head-shaking nystagmus
- MeSH:
Benign Paroxysmal Positional Vertigo;
Dizziness;
Humans;
Incidence;
Lost to Follow-Up;
Retrospective Studies;
Treatment Outcome;
Vestibular Diseases
- From:Journal of the Korean Balance Society
2017;16(4):129-134
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: The purpose of this study was to examine the clinical manifestations and significance of pseudo-spontaneous nystagmus (PSN) and head-shaking nystagmus (HSN) in horizontal canal benign paroxysmal positional vertigo (HC-BPPV). METHODS: Two hundred fifty-two patients diagnosed as HC-BPPV were reviewed retrospectively. After excluding 55 patients with ipsilateral vestibular diseases, multiple canal BPPV, or those who were lost to follow-up, we analyzed the direction of PSN and HSN in patients with HC-BPPV. We also compared the clinical characteristics and treatment outcome between PSN-positive and PSN-negative groups. RESULTS: Our study included 197 patients composed of 80 patients with geotropic HC-BPPV and 117 patients with apogeotropic HC-BPPV. PSN was observed in 13.7% patients and HSN was observed in 45.2%. The incidence of HSN was higher in apogeotropic HC-BPPV, while the proportion of PSN was not statistically significant between the two subtypes. There was no directional preponderance in geotropic HC-BPPV, while ipsilesional PSN and contralesional HSN showed higher incidence in apogeotropic HC-BPPV. The dizziness handicap inventory score in the PSN-positive group was higher than that in the PSN-negative group (p<0.001), and the duration of symptom onset in the PSN-positive group was shorter than that in the PSN-negative group (p=0.047). However, there was no significant difference in the treatment outcome between the two groups. CONCLUSIONS: The incidence of HSN was higher than that of PSN in patients with apogeotropic HC-BPPV. Patients with HC-BPPV showing PSN demonstrated more severe initial symptoms and visited the hospital in a shorter period of time after the onset of symptoms.
