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
;
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;Department of Otolaryngology Head and Neck Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, 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.
