The clinical significance of direction-fixed mono-positional apogeotropic horizontal nystagmus
Copyright © 2022 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy..
Objective: A mono-positional persistent, direction-fixed apogeotropic nystagmus (MPosApoNy) is very challenging for the neuro-otologist. MPosApoNy can be found in patients suffering from a partially compensated acute unilateral vestibulopathy; with a normal caloric test, one can speculate the presence of "trapped" otolithic debris located close to the ampulla of the horizontal semicircular canal.
Methods: Among 957 patients suffering from vertigo and dizziness, we selected 53 cases of MPosApoNy.
Results: In 28 patients, caloric test showed a canal paresis on the same side of the MPosApoNy. In the remaining 25 cases, MPosApoNy was the only clinical finding. We hypothesised the presence of horizonal canal lithiasis and patients were treated with a Gufoni manoeuvre, followed by a forced prolonged position.
Conclusions: Performing bedside examination in a patient suffering from vertigo, the presence of MPosApoNy may be due to: a) facilitation of a subclinical nystagmus due to the mechanism of apogeotropic reinforcement; b) horizontal canal lithiasis with 'trapped' otoliths close to the ampulla. The disappearance of MPosApoNy following a repositioning manoeuvre or conversion in a typical form of canalolithiasis may represent the best method to confirm this hypothesis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale - 42(2022), 3 vom: 01. Juni, Seite 287-292 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gufoni, Mauro [VerfasserIn] |
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| Links: |
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| Themen: |
Apogeotropic nystagmus |
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| Anmerkungen: |
Date Completed 27.07.2022 Date Revised 09.08.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.14639/0392-100X-N1824 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM344002322 |
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| 245 | 1 | 4 | |a The clinical significance of direction-fixed mono-positional apogeotropic horizontal nystagmus |
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| 500 | |a Date Completed 27.07.2022 | ||
| 500 | |a Date Revised 09.08.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale, Rome, Italy. | ||
| 520 | |a Objective: A mono-positional persistent, direction-fixed apogeotropic nystagmus (MPosApoNy) is very challenging for the neuro-otologist. MPosApoNy can be found in patients suffering from a partially compensated acute unilateral vestibulopathy; with a normal caloric test, one can speculate the presence of "trapped" otolithic debris located close to the ampulla of the horizontal semicircular canal | ||
| 520 | |a Methods: Among 957 patients suffering from vertigo and dizziness, we selected 53 cases of MPosApoNy | ||
| 520 | |a Results: In 28 patients, caloric test showed a canal paresis on the same side of the MPosApoNy. In the remaining 25 cases, MPosApoNy was the only clinical finding. We hypothesised the presence of horizonal canal lithiasis and patients were treated with a Gufoni manoeuvre, followed by a forced prolonged position | ||
| 520 | |a Conclusions: Performing bedside examination in a patient suffering from vertigo, the presence of MPosApoNy may be due to: a) facilitation of a subclinical nystagmus due to the mechanism of apogeotropic reinforcement; b) horizontal canal lithiasis with 'trapped' otoliths close to the ampulla. The disappearance of MPosApoNy following a repositioning manoeuvre or conversion in a typical form of canalolithiasis may represent the best method to confirm this hypothesis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a apogeotropic nystagmus | |
| 650 | 4 | |a benign paroxysmal positional vertigo | |
| 650 | 4 | |a canalolithiasis | |
| 650 | 4 | |a horizontal semicircular canal | |
| 650 | 4 | |a positional nystagmus | |
| 700 | 1 | |a Casani, Augusto Pietro |e verfasserin |4 aut | |
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