Direction-changing spontaneous nystagmus in patients with dizziness

Park, Joon Yong; Shin, Jung Eun; Kim, Chang-Hee

doi:10.1007/s00405-022-07761-5

Cited by 2 publications

(3 citation statements)

References 46 publications

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“…The nystagmus had slow-phase velocity that was weak, around 1–2°/s, and was seen during the interictal period. They also reported that hyperventilation-induced nystagmus and head-shaking nystagmus were not direction-changing in either patient [ 41 ]. They could not establish periodicity because it was a retrospective study, and not all of the recordings were standardized for a certain duration of time; hence, they could not establish whether it was periodic or aperiodic direction-changing spontaneous nystagmus that was actually recorded.…”

Section: Discussionmentioning

confidence: 99%

“…Also, they did mention variability as to when vestibular function tests were performed with regard to the onset of symptoms. And, finally, the question remains as to whether these findings are clinically relevant or not [ 41 ]. Very recently, Kim et al published two cases of opsoclonus induced by horizontal head-shaking in vestibular migraine patients.…”

Section: Discussionmentioning

confidence: 99%

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Vestibular and Oculomotor Findings in Vestibular Migraine Patients

et al. 2023

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Background: Vestibular migraine (VM) is the most frequent etiology of recurrent spontaneous episodic vertigo. Vestibular and oculomotor abnormalities have been described in VM; however, the diagnosis is currently based on symptoms. The objective of this study was to determine the most frequent abnormalities in videonystagmography (VNG), caloric testing (Cal) and video head impulse test (vHIT) in patients with VM. Methods: A retrospective cohort study was conducted, including all VM and probable VM patients seen from January 2021 to July 2022. Demographics, auditory symptoms and results via VNG, Cal and vHIT were evaluated. VNG results were compared with a control group. Results: Sixty patients, 81.7% with VM and 18.3% with probable vestibular migraine, were included. VNG revealed the following abnormalities: 21.7% spontaneous nystagmus; 33.3% positional nystagmus, mostly central; 26.7% optokinetic nystagmus; 56.7% smooth pursuit abnormalities and 70% saccade test abnormalities, mostly velocity and latency. An abnormal unilateral caloric response was seen in 22.9%, while vHIT revealed a low gain in at least one canal in 21.7%, and saccades were seen in at least one canal with normal gains in 18.3%. Concordant results between Cal and lateral vHIT were seen in 77.1% of cases. Conclusions: Although VM is a clinical diagnosis, vestibular and oculomotor abnormalities are commonly seen. The most frequent oculomotor findings were an abnormal saccade test, abnormal smooth pursuit and central positional nystagmus.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Vestibular and Oculomotor Findings in Vestibular Migraine Patients

et al. 2023

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“…BPPV is similar in nature, so a differential diagnosis should also include this disease. The possible ambiguous symptomatology of VP may require an ENT specialist to differentiate this pathology from Ménière's disease or migraine-induced vestibular disorder [29]. Complaints of VP may be accompanied by auditory symptoms -most often tinnitus, less often sensorineural hearing loss, and visual symptoms (nystagmus, often induced by hyperventilation and oscillopsia) [30][31][32][33][34][35].…”

Section: Introductionmentioning

confidence: 99%

Literature review and two study cases of vestibular paroxysmia from an otorhinolaryngology centre

Jankowska,

Pietrzak,

Rosiak

et al. 2023

J Hear Sci

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IntroductionVestibular paroxysmia is a rare disorder of the balance system manifested by recurrent attacks of vertigo, the etiology of which is associated with compression of a blood vessel on the vestibulocochlear nerve. The exact mechanism for triggering the symptoms is not fully understood. The condition occurs in all age groups and without gender predilection. The purpose of the study was to review the literature on vestibular paroxysmia, discuss criteria for the diagnosis of the disease, diagnostic management, proposed therapy, and present clinical cases from the authors’ own practice.Material and methodsA review of the scientific literature was conducted via the PubMed database using the keywords “vestibular paroxysmia,” “neurovascular conflict cochlear nerve,” and “neurovascular conflict vestibular nerve”. PRISMA guidelines for systematic reviews were applied.ResultsThere were 146 publications found; after analysis of titles and abstracts, 56 were included in the review; another 10 manuscripts were identified during reference review. Among them, 11 studies were devoted to diagnostic imaging, 19 described the clinical course of the condition based on retrospective studies, 15 were case reports, and 11 other reports and reviews. Following evaluation of this literature, two clinical cases of vestibular paroxysm from the authors’ own practice are described. These cases are presented along with their diagnosis and therapy.ConclusionsImaging studies are of significant value in diagnosing many vascular–neural conflicts, but for vestibular paroxysmia the diagnosis is made on the basis of clinical symptoms and according to the division proposed by the Bárány Society in 2016. Pharmacological therapy is recommended, and response to therapy is one of the criteria for diagnosing the condition. Surgical treatment is reserved for the most severe cases.

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Direction-changing spontaneous nystagmus in patients with dizziness

Cited by 2 publications

References 46 publications

Vestibular and Oculomotor Findings in Vestibular Migraine Patients

Vestibular and Oculomotor Findings in Vestibular Migraine Patients

Literature review and two study cases of vestibular paroxysmia from an otorhinolaryngology centre

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