Background
and Objectives : Traditionally, down beat nystagmus is regarded as a sign of central nervous system
dysfunction. But, several years has passed since Herdman et al reported the down beat nystagmus developed during
treatment maneuvers for posterior semicircular canal benign paroxysmal positional vertigo(BPPV). We undertook this
study to evaluate the character and clinical analysis of the positional or positioning down beat nystagmus, to discuss
the clinical significance of positional or positioning down beat nystagmus as a diagnostic criteria of superior
semicircular canal BPPV, and to propose the new treatment method.
Materials and Method : From November 1999 to March 2004, we sampled the 103 patients with positional or
positioning down beat nystagmus. Of these patients, we selected 16 patients except for the patients with central nervous
system dysfunction, nonspecific or artifact result, idiopathic origin.
Results
: All of 16 patients had no sign and radiologic result of central nervous system disorder. 10 patients was
reported or suspected the diagnosis of posterior semicircular canal BPPV. Fatigability was reported in 9 patients and
reversibility was reported in 1 patient. Average latency was checked less than 2 seconds.
Conclusion
: Although the diagnostic criteria of superior semicircular canal BPPV that we reported was not
controversial, we expect that this criteria is useful in diagnosis for patients with atypical positional or positioning down
beat nystagmus. And the new treatment method that we reported will has the better results than previous method.
Key Words : Benign paroxysmal vertigo, Positional vertigo, Superior semicircular cana