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Research in Vestibular Science > Accepted Articles
Pseudo-spontaneous nystagmus and head-shaking nystagmus in horizontal canal benign paroxysmal positional vertigo
Yong Gook Shin, Ja Won Gu, Jin Wook Kang, Mee Hyun Song, Dae Bo Shim
Department of Otorhinolaryngology, Myongji Hospital, Seonam University College of Medicine, Gyeonggi-do, Korea
Correspondence  Dae Bo Shim ,Tel: 031-810-5451, Fax: 031-969-0500, Email: lovend77@gmail.com
Received: October 16, 2017;  Accepted: October 28, 2017.  Published online: October 28, 2017.
Objective:   The purpose of this study was to examine the clinical manifestations and significance of pseudo-spontaneous nystagmus (PSN) and head-shaking nystagmus (HSN) in horizontal canal benign paroxysmal positional vertigo (HC-BPPV).
Method:   Two hundred fifty-two patients diagnosed as HC-BPPV were reviewed retrospectively. After excluding 55 patients with ipsilateral vestibular diseases, multiple canal BPPV, or those who were lost to follow-up, we analyzed the direction of PSN and HSN in patients with HC-BPPV. We also compared the clinical characteristics and treatment outcome between PSN-positive and PSN-negative groups.
Results:   Our study included 197 patients composed of 80 patients with geotropic HC-BPPV and 117 patients with apogeotropic HC-BPPV. PSN was observed in 13.7% patients and HSN was observed in 45.2%. The incidence of HSN was higher in apogeotropic HC-BPPV, while the proportion of PSN was not statistically significant between the two subtypes. There was no directional preponderance in geotropic HC-BPPV, while ipsilesional PSN and contralesional HSN showed higher incidence in apogeotropic HC-BPPV. The dizziness handicap inventory score in the PSN-positive group was higher than that in the PSN-negative group (p<0.001), and the duration of symptom onset in the PSN-positive group was shorter than that in the PSN-negative group (p=0.047). However, there was no significant difference in the treatment outcome between the two groups.
Conclusion:   The incidence of HSN was higher than that of PSN in patients with apogeotropic HC- BPPV. Patients with HC-BPPV showing PSN demonstrated more severe initial symptoms and visited the hospital in a shorter period of time after the onset of symptoms.
Keywords: Benign paroxysmal positional vertigo; Horizontal canal; Spontaneous nystagmus; Head-shaking nystagmus
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