Peripheral Downbeat Positional Nystagmus: Apogeotropic Posterior Canal or Anterior Canal BPPV.
Identifieur interne : 000050 ( Main/Curation ); précédent : 000049; suivant : 000051Peripheral Downbeat Positional Nystagmus: Apogeotropic Posterior Canal or Anterior Canal BPPV.
Auteurs : Janet Odry Helminski [États-Unis]Source :
- Journal of neurologic physical therapy : JNPT [ 1557-0584 ] ; 2019.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Canaux semicirculaires osseux (physiopathologie), Femelle (MeSH), Humains (MeSH), Nystagmus pathologique (physiopathologie), Nystagmus pathologique (étiologie), Vertige positionnel paroxystique bénin (complications), Vertige positionnel paroxystique bénin (physiopathologie), Épreuves vestibulaires (MeSH).
- MESH :
- physiopathologie : Canaux semicirculaires osseux, Nystagmus pathologique, Vertige positionnel paroxystique bénin.
- étiologie : Nystagmus pathologique.
- complications : Adulte, Adulte d'âge moyen, Femelle, Humains, Vertige positionnel paroxystique bénin, Épreuves vestibulaires.
English descriptors
- KwdEn :
- Adult (MeSH), Benign Paroxysmal Positional Vertigo (complications), Benign Paroxysmal Positional Vertigo (physiopathology), Female (MeSH), Humans (MeSH), Middle Aged (MeSH), Nystagmus, Pathologic (etiology), Nystagmus, Pathologic (physiopathology), Semicircular Canals (physiopathology), Vestibular Function Tests (MeSH).
- MESH :
- complications : Benign Paroxysmal Positional Vertigo.
- etiology : Nystagmus, Pathologic.
- physiopathology : Benign Paroxysmal Positional Vertigo, Nystagmus, Pathologic, Semicircular Canals.
- Adult, Female, Humans, Middle Aged, Vestibular Function Tests.
Abstract
BACKGROUND AND PURPOSE
Downbeat nystagmus (DBN) during the Dix-Hallpike test (DHT) suggests excitation of the anterior canal (AC) or inhibition of the posterior canal (PC) underlying benign paroxysmal positional vertigo (BPPV). This case series describes 2 individuals presenting with DBN in positional testing suggestive of a PC BPPV variant termed apogeotropic PC-BPPV and due to inhibition of the PC.
CASE DESCRIPTIONS
Case 1 illustrates a DBN during positional testing (PC inhibition) that changes to an upbeating nystagmus (PC excitation) representing the otoconial material changing location and direction of movement within the PC. Case 2 describes a canal jam in the nonampullary segment of the PC.
DIFFERENTIAL DIAGNOSIS
Apogeotropic PC-BPPV can cause DBN due to inhibition of the vestibular afferent. Apogeotropic PC-BPPV may be due to a canal jam of debris within the nonampullary segment or cupulolithiasis with debris attached to the inferior-most aspect of the cupula within the PC. It can be difficult to differentiate AC-BPPV from the apogeotropic PC-BPPV variant. In both forms, the affected canal may be provoked in 1 or both positions of the DHT and straight head hanging position. However, in AC-BPPV there may only be a slight or absent torsional component toward the involved ear. In apogeotropic PC-BPPV, a strong torsion away from the involved ear is typically observed. The straight head hanging position may resolve AC-BPPV or convert apogeotropic PC-BPPV to typical PC-BPPV.
SUMMARY
These 2 cases illustrate atypical variants of BPPV that clinicians must consider in their interpretation of DBN during positional testing, particularly in the absence of other neurological signs.
DOI: 10.1097/NPT.0000000000000267
PubMed: 30883487
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pubmed:30883487Le document en format XML
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This case series describes 2 individuals presenting with DBN in positional testing suggestive of a PC BPPV variant termed apogeotropic PC-BPPV and due to inhibition of the PC.</p></div><div type="abstract" xml:lang="en"><p><b>CASE DESCRIPTIONS</b></p><p>Case 1 illustrates a DBN during positional testing (PC inhibition) that changes to an upbeating nystagmus (PC excitation) representing the otoconial material changing location and direction of movement within the PC. Case 2 describes a canal jam in the nonampullary segment of the PC.</p></div><div type="abstract" xml:lang="en"><p><b>DIFFERENTIAL DIAGNOSIS</b></p><p>Apogeotropic PC-BPPV can cause DBN due to inhibition of the vestibular afferent. Apogeotropic PC-BPPV may be due to a canal jam of debris within the nonampullary segment or cupulolithiasis with debris attached to the inferior-most aspect of the cupula within the PC. It can be difficult to differentiate AC-BPPV from the apogeotropic PC-BPPV variant. In both forms, the affected canal may be provoked in 1 or both positions of the DHT and straight head hanging position. However, in AC-BPPV there may only be a slight or absent torsional component toward the involved ear. In apogeotropic PC-BPPV, a strong torsion away from the involved ear is typically observed. The straight head hanging position may resolve AC-BPPV or convert apogeotropic PC-BPPV to typical PC-BPPV.</p></div><div type="abstract" xml:lang="en"><p><b>SUMMARY</b></p><p>These 2 cases illustrate atypical variants of BPPV that clinicians must consider in their interpretation of DBN during positional testing, particularly in the absence of other neurological signs.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">30883487</PMID><DateCompleted><Year>2020</Year><Month>06</Month><Day>24</Day></DateCompleted><DateRevised><Year>2020</Year><Month>06</Month><Day>24</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1557-0584</ISSN><JournalIssue CitedMedium="Internet"><Volume>43 Suppl 2</Volume><PubDate><Year>2019</Year><Month>04</Month></PubDate></JournalIssue><Title>Journal of neurologic physical therapy : JNPT</Title><ISOAbbreviation>J Neurol Phys Ther</ISOAbbreviation></Journal><ArticleTitle>Peripheral Downbeat Positional Nystagmus: Apogeotropic Posterior Canal or Anterior Canal BPPV.</ArticleTitle><Pagination><MedlinePgn>S8-S13</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/NPT.0000000000000267</ELocationID><Abstract><AbstractText Label="BACKGROUND AND PURPOSE">Downbeat nystagmus (DBN) during the Dix-Hallpike test (DHT) suggests excitation of the anterior canal (AC) or inhibition of the posterior canal (PC) underlying benign paroxysmal positional vertigo (BPPV). This case series describes 2 individuals presenting with DBN in positional testing suggestive of a PC BPPV variant termed apogeotropic PC-BPPV and due to inhibition of the PC.</AbstractText><AbstractText Label="CASE DESCRIPTIONS">Case 1 illustrates a DBN during positional testing (PC inhibition) that changes to an upbeating nystagmus (PC excitation) representing the otoconial material changing location and direction of movement within the PC. Case 2 describes a canal jam in the nonampullary segment of the PC.</AbstractText><AbstractText Label="DIFFERENTIAL DIAGNOSIS">Apogeotropic PC-BPPV can cause DBN due to inhibition of the vestibular afferent. Apogeotropic PC-BPPV may be due to a canal jam of debris within the nonampullary segment or cupulolithiasis with debris attached to the inferior-most aspect of the cupula within the PC. It can be difficult to differentiate AC-BPPV from the apogeotropic PC-BPPV variant. In both forms, the affected canal may be provoked in 1 or both positions of the DHT and straight head hanging position. However, in AC-BPPV there may only be a slight or absent torsional component toward the involved ear. In apogeotropic PC-BPPV, a strong torsion away from the involved ear is typically observed. The straight head hanging position may resolve AC-BPPV or convert apogeotropic PC-BPPV to typical PC-BPPV.</AbstractText><AbstractText Label="SUMMARY">These 2 cases illustrate atypical variants of BPPV that clinicians must consider in their interpretation of DBN during positional testing, particularly in the absence of other neurological signs.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Helminski</LastName><ForeName>Janet Odry</ForeName><Initials>JO</Initials><AffiliationInfo><Affiliation>Physical Therapy Program, Midwestern University, Downers Grove, Illinois.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Neurol Phys Ther</MedlineTA><NlmUniqueID>101193365</NlmUniqueID><ISSNLinking>1557-0576</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D065635" MajorTopicYN="N">Benign Paroxysmal Positional Vertigo</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009759" MajorTopicYN="N">Nystagmus, Pathologic</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012665" MajorTopicYN="N">Semicircular Canals</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014724" MajorTopicYN="N">Vestibular Function Tests</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>3</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>3</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>6</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">30883487</ArticleId><ArticleId IdType="doi">10.1097/NPT.0000000000000267</ArticleId><ArticleId IdType="pii">01253086-201904001-00003</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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