Downbeat nystagmus (DBN) is a neuro-otological finding frequently encountered by clinicians dealing with patients with vertigo. Since DBN is a finding that should be understood because of central vestibular dysfunction, it is necessary to know how to frame it promptly to suggest the correct diagnostic-therapeutic pathway to the patient. As knowledge of its pathophysiology has progressed, the importance of this clinical sign has been increasingly understood. At the same time, clinical diagnostic knowledge has increased, and it has been recognized that this sign may occur sporadically or in association with others within defined clinical syndromes. Thus, in many cases, different therapeutic solutions have become possible. In our work, we have attempted to systematize current knowledge about the origin of this finding, the clinical presentation and current treatment options, to provide an overview that can be used at different levels, from the general practitioner to the specialist neurologist or neurotologist.
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http://dx.doi.org/10.3389/fneur.2024.1394859 | DOI Listing |
J Clin Med
November 2024
ENT Department, University Hospital of Salamanca, 37007 Salamanca, Spain.
: Skull vibration-induced nystagmus (SVIN) has become a validated tool for evaluating the vestibular function. The presence of SVIN is a useful indicator of the asymmetry of vestibular function between the two ears. In unilateral vestibular loss, a 100 Hz bone-conducted vibration given to either mastoid immediately causes a primarily horizontal nystagmus.
View Article and Find Full Text PDFJ Am Acad Audiol
May 2024
Section of Audiology, Vestibular and Balance Disorders Program, Head and Neck Department, Integrated Surgical Institute, Cleveland Clinic, Cleveland, Ohio.
Background: The video head impulse test measures high-frequency vestibulo-ocular function of all six semicircular canals. Isolated semicircular canal dysfunction has been correlated with several peripheral and central vestibular etiologies. Selective bilateral posterior canal dysfunction is a trend seen in the clinical setting but less commonly reported in the medical literature.
View Article and Find Full Text PDFCerebellum
December 2024
NeuroMetrology Lab, Nuffield Department of Clinical Neurosciences, Clinical Neurology, Medical Sciences Division, University of Oxford, Oxford, OX3 9DU, UK.
Whereas several studies have reported on quantitative oculomotor and vestibular measurements in spinocerebellar ataxia type 6 (SCA6), selecting the most suitable paradigms remains challenging. We aimed to address this knowledge gap through a systematic literature review and providing disease-specific recommendations for a tailored set of eye-movement recordings in SCA6. A literature search (MEDLINE, Embase) was performed focusing on studies reporting on quantitative oculomotor and/or vestibular measurements in SCA6-patients.
View Article and Find Full Text PDFJ Neurol Phys Ther
January 2025
College of Health Professions, Rosalind Franklin University, North Chicago, Illinois.
Background And Purpose: Atypical posterior canal (pc) benign paroxysmal positional vertigo (BPPV) may be caused by cupulolithiasis (cu), short arm canalithiasis (ca), or jam. The purpose of this study was to describe the clinical presentation and differential diagnosis of pc-BPPV-cu and short arm canalithiasis.
Methods: This retrospective observation study identified persons with atypical pc-BPPV based on history and findings from four positional tests.
Cureus
October 2024
Neuro-ophthalmology, Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee, USA.
Neuromyelitis optica (NMO), an autoimmune disease, typically presents with loss of vision and myelopathic signs. NMO may be associated with antibodies selective for aquaporin-4 (AQP4), a water channel located within the optic nerves and spinal cord.AQP4 is distributed in the periventricular region, corpus callosum, magnocellular nuclei of the hypothalamus, and brain stem.
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