3D analysis of benign positional nystagmus due to cupulolithiasis in posterior semicircular canal

Imai, Toshio; Takeda, Noriaki; Ito, Mahito; Sekine, Kazunori; Sato, Go; Midoh, Yoshihiro; Nakamae, Koji; Kubo, Takeshi

doi:10.1080/00016480802566303

Cited by 59 publications

(62 citation statements)

References 16 publications

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“…Cupulolithiasis of the posterior canal has rarely been described [43]. Positional nystagmus may disappear when the head is further reclined in the Dix-Hallpike position [43].…”

Section: Commentsmentioning

confidence: 99%

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Benign paroxysmal positional vertigo: Diagnostic criteria

Brevern

Bertholon

Brandt

et al. 2015

VES

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Abstract. This article presents operational diagnostic criteria for benign paroxysmal positional vertigo (BPPV), formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society. The classification reflects current knowledge of clinical aspects and pathomechanisms of BPPV and includes both established and emerging syndromes of BPPV. It is anticipated that growing understanding of the disease will lead to further development of this classification.

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“…Cupulolithiasis of the posterior canal has rarely been described [43]. Positional nystagmus may disappear when the head is further reclined in the Dix-Hallpike position [43].…”

Section: Commentsmentioning

confidence: 99%

“…Positional nystagmus may disappear when the head is further reclined in the Dix-Hallpike position [43]. A "reversed Dix-Hallpike maneuver" with the head bent forward 90…”

Section: Commentsmentioning

confidence: 99%

Benign paroxysmal positional vertigo: Diagnostic criteria

Brevern

Bertholon

Brandt

et al. 2015

VES

Self Cite

581

502

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“…The normal vectors of the planes of the semicircular canals are inserted into the sphere in Step (10). The mean vector of the unit vectors and the angles between the unit vectors and this mean vector are computed in Step (11) and all the vectors are mapped on the sphere in Step (12). The angles between the mean vector and normal vectors are calculated and the closest normal vector is chosen in Steps (13) and (14).…”

Section: Methodsmentioning

confidence: 99%

“…Two recent nystagmus studies have been accomplished with video-oculography, but they did not consider modeling and, being purely medical studies, the descriptive presentations employed were very limited as to signal analysis. 11 right eye FIGURE 1. Spontaneous nystagmus: the uppermost signal (green) in either part is vertical, the middle signal (red) is torsional, and the lowest signal (blue) is horizontal.…”

Section: Introductionmentioning

confidence: 99%

“…14 Scleral search coil measurements 3 contained the signal of one patient, their purpose being medical research without actual modeling. In the articles, 11,20 they reported three-dimensional video-oculography nystagmus measurements, but the latter included only one subject and neither considered modeling at all. Modeling was not possible before, for the first time that exact anatomical images were measured to calculate average angles between the planes of semicircular canals on the basis of several subjects.…”

Section: Introductionmentioning

confidence: 99%

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Signal Analysis of Three-dimensional Nystagmus for Otoneurological Investigations

et al. 2010

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Three-dimensional signal analysis can be applied to eye movements called nystagmus in order to study otoneurological patients suffering from vertigo and other balance problems. We developed an analysis and modeling algorithm for three-dimensional nystagmus measured by a video-oculography system. We were also interested in verifying an otoneurological hands-on convention called Ewald's first law in a strict physiological sense in vestibular patients. We recorded nystagmus from 42 patients all suffering from vertigo or dizziness. The underlying pathology was unilateral in 39 patients, bilateral in one patient, and central in two patients. Video-oculography was used to record three-dimensional nystagmus to separately produce horizontal, vertical, and torsional signals for each eye. On the basis of signal analysis techniques and straightforward vector calculus, we were able to recognize slow phases of nystagmus to compute their angular velocities to estimate from which part of the inner ear the disorder originated. We found that for all 42 patients the plane of one of the two horizontal semicircular canals was the closest. We were able to quantitatively estimate the influence of different semicircular canals, and, despite the pathology, horizontal canals seemed to be predominant in driving the nystagmus. The signal analysis and modeling algorithm developed is effective in studying otoneurological problems registered with nystagmus and opens new insights in three-dimensional nystagmography. Our results strongly support Ewald's first law.

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Posterior canal benign paroxysmal positional vertigo with long duration: Heavy or light cupula?

Kim

Shin

Kim

et al. 2023

Laryngoscope Investig Oto

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ObjectiveTo investigate the characteristics of positional nystagmus in posterior semicircular canal (PSCC) benign paroxysmal positional vertigo (BPPV) patients with longer durations, and to discuss the possible underlying mechanism of this nystagmus.MethodsWe conducted a retrospective review, and enrolled 118 consecutive patients with unilateral PSCC BPPV. The duration of nystagmus during a Dix‐Hallpike test was classified into short (<1 min) and long (≥1 min) durations. For the identification of a neutral point in PSCC BPPV patients with long durations, the patient's head was turned 45° to the lesioned side to set the affected PSCC on the sagittal plane, and the disappearance of positional nystagmus was investigated in a pitch plane.ResultsAmong 118 patients with PSCC BPPV, positional nystagmus during a Dix‐Hallpike test showed short durations (<1 min) in 112 patients and long durations (≥1 min) in 6 patients. Of 6 PSCC BPPV patients with a long duration, a neutral point was identified in 5 patients whose nystagmus lasted for longer than 2 min; interestingly, a neutral point was observed when the patient's head was slightly tilted backward in all 5 patients.ConclusionConsidering that a neutral position was identified when the patient's head was slightly tilted backward while keeping the head turned 45° to the right or left, we assume that the light cupula condition of the ipsilateral PSCC or the contralateral anterior semicircular canal, and not PSCC BPPV cupulolithiasis, could be responsible for the occurrence of persistent torsional‐upbeating nystagmus in a Dix‐Hallpike test.Level of Evidence4

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3D analysis of benign positional nystagmus due to cupulolithiasis in posterior semicircular canal

Cited by 59 publications

References 16 publications

Benign paroxysmal positional vertigo: Diagnostic criteria

Benign paroxysmal positional vertigo: Diagnostic criteria

Signal Analysis of Three-dimensional Nystagmus for Otoneurological Investigations

Posterior canal benign paroxysmal positional vertigo with long duration: Heavy or light cupula?

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