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Diversity of head shaking nystagmus in peripheral vestibular disease.
Otol Neurotol. 2012 Jun; 33(4):634-9.ON

Abstract

OBJECTIVES

To evaluate the characteristics of head shaking nystagmus in various peripheral vestibular diseases.

STUDY DESIGN

Retrospective case series.

SETTING

Tertiary referral center.

MATERIALS AND METHODS

Data of 235 patients with peripheral vestibular diseases including vestibular neuritis, Ménière's disease, and benign paroxysmal positional vertigo, were retrospectively analyzed. All subjects presented between August 2009 and July 2010. Patients were tested for vestibular function including head shaking nystagmus and caloric information. Regarding vestibular neuritis, all tests were again performed during the 1-month follow-up. Head shaking nystagmus was classified as monophasic or biphasic and, according to the affected ear, was divided as ipsilesional or contralesional.

RESULTS

Of the 235 patients, 87 patients revealed positive head shaking nystagmus. According to each disease, positive rates of head shaking nystagmus were as follows: 35 (100%) of 35 cases of vestibular neuritis, 11 (68.8%) of 16 cases of Ménière's disease, and 41 (22.2%) of 184 cases of benign paroxysmal positional vertigo. All cases of vestibular neuritis initially presented as a monophasic, contralesional beating, head shaking nystagmus. However, 1 month after first visit, the direction of nystagmus was changed to biphasic (contralesional first then ipsilesional beating) in 25 cases (72.5%) but not in 10 cases (27.5%). There was a significant correlation between the degree of initial caloric weakness and the biphasic conversion of head shaking nystagmus (p = 0.02).

CONCLUSION

In 72.5% of vestibular neuritis cases, head shaking nystagmus was converted to biphasic during the subacute period. The larger the initial canal paresis was present, the more frequent the biphasic conversion of head shaking nystagmus occurred. However, Ménière's disease and benign paroxysmal positional vertigo did not have specific patterns of head shaking nystagmus.

Authors+Show Affiliations

Department of Otolaryngology - Head and Neck Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22525213

Citation

Kim, Min-Beom, et al. "Diversity of Head Shaking Nystagmus in Peripheral Vestibular Disease." Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, vol. 33, no. 4, 2012, pp. 634-9.
Kim MB, Huh SH, Ban JH. Diversity of head shaking nystagmus in peripheral vestibular disease. Otol Neurotol. 2012;33(4):634-9.
Kim, M. B., Huh, S. H., & Ban, J. H. (2012). Diversity of head shaking nystagmus in peripheral vestibular disease. Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 33(4), 634-9. https://doi.org/10.1097/MAO.0b013e31824950c7
Kim MB, Huh SH, Ban JH. Diversity of Head Shaking Nystagmus in Peripheral Vestibular Disease. Otol Neurotol. 2012;33(4):634-9. PubMed PMID: 22525213.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diversity of head shaking nystagmus in peripheral vestibular disease. AU - Kim,Min-Beom, AU - Huh,Se Hyung, AU - Ban,Jae Ho, PY - 2012/4/25/entrez PY - 2012/4/25/pubmed PY - 2012/9/28/medline SP - 634 EP - 9 JF - Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology JO - Otol Neurotol VL - 33 IS - 4 N2 - OBJECTIVES: To evaluate the characteristics of head shaking nystagmus in various peripheral vestibular diseases. STUDY DESIGN: Retrospective case series. SETTING: Tertiary referral center. MATERIALS AND METHODS: Data of 235 patients with peripheral vestibular diseases including vestibular neuritis, Ménière's disease, and benign paroxysmal positional vertigo, were retrospectively analyzed. All subjects presented between August 2009 and July 2010. Patients were tested for vestibular function including head shaking nystagmus and caloric information. Regarding vestibular neuritis, all tests were again performed during the 1-month follow-up. Head shaking nystagmus was classified as monophasic or biphasic and, according to the affected ear, was divided as ipsilesional or contralesional. RESULTS: Of the 235 patients, 87 patients revealed positive head shaking nystagmus. According to each disease, positive rates of head shaking nystagmus were as follows: 35 (100%) of 35 cases of vestibular neuritis, 11 (68.8%) of 16 cases of Ménière's disease, and 41 (22.2%) of 184 cases of benign paroxysmal positional vertigo. All cases of vestibular neuritis initially presented as a monophasic, contralesional beating, head shaking nystagmus. However, 1 month after first visit, the direction of nystagmus was changed to biphasic (contralesional first then ipsilesional beating) in 25 cases (72.5%) but not in 10 cases (27.5%). There was a significant correlation between the degree of initial caloric weakness and the biphasic conversion of head shaking nystagmus (p = 0.02). CONCLUSION: In 72.5% of vestibular neuritis cases, head shaking nystagmus was converted to biphasic during the subacute period. The larger the initial canal paresis was present, the more frequent the biphasic conversion of head shaking nystagmus occurred. However, Ménière's disease and benign paroxysmal positional vertigo did not have specific patterns of head shaking nystagmus. SN - 1537-4505 UR - https://www.unboundmedicine.com/medline/citation/22525213/Diversity_of_head_shaking_nystagmus_in_peripheral_vestibular_disease_ L2 - https://doi.org/10.1097/MAO.0b013e31824950c7 DB - PRIME DP - Unbound Medicine ER -