Review of Positional Nystagmus
Abstract Introduction and objective: Any change of position of the head (dynamic or static) can trigger a nystagmus or increase the spontaneous. This nystagmus we call it positional. We intend to review in this chapter its definition, clinical features, etiology and the way of exploring it. Method: narrative review. Results: Positional vertigo is the most frequent vestibular disorder, and most of the times of peripheral cause. Characteristics of nystagmus or its association with other neurological symptoms are sufficient grounds to request a magnetic resonance, which will provide additional information on very few occasions. Discussion: The study of the positional nystagmus as a procedure to rule out central pathology has lost much of its relevance. Signs that Nylén defined mixed findings peripheral and central, making complex classification. Conclusion: Regardless of how to bring the patient change position (very slow or fast), if it appears an atypical nystagmus should rule out a central origin.
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Aschan G. The pathogenesis of positional nystagmus. Acta Otolaryngol Suppl. 1961;159:90-3. PMID: 13684672. / https://doi.org/10.3109/00016486109120549
Baloh RW, Kerber KA. Clinical neurophysiology of the vestibular system. Oxford University Press. 4ª Ed. 2011. Cap. 6; pp.149-170.
Barber HO. Positional nystagmus. Otolaryngol Head Neck Surg. 1984;92(6):649-55. PMID: 6440083 / https://doi.org/10.1177/019459988409200611
Bertholon P, Tringali S, Faye MB, Antoine JC, Martin C. Prospective study of positional nystagmus in 100 consecutive patients. Ann Otol Rhinol Laryngol. 2006;115(8):587-94. PMID: 16944657. / https://doi.org/10.1177/000348940611500804
Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE. Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res. 2009;19(1-2):1-13. doi: 10.3233/VES-2009-0343. PMID: 19893191.
Bisdorff AR, Staab JP, Newman-Toker DE. Overview of the International Classification of Vestibular Disorders. Neurol Clin. 2015;33(3):541-50, vii. doi: 10.1016/j.ncl.2015.04.010. Review. PMID: 26231270. / https://doi.org/10.1016/j.ncl.2015.04.010
Brandt T. Positional and positioning vertigo and nystagmus. J Neurol Sci. 1990;95(1):3-28. PMID: 2187057. / https://doi.org/10.1016/0022-510X(90)90113-2
Bronstein A, Lempert T. Dizziness. Cambridge University Press. 1ª Ed. 2007. Cap. 5; pp.131-156.
Chang MB, Bath AP, Rutka JA. Are all atypical positional nystagmus patterns reflective of central pathology?. J Otolaryngol. 2001;30(5):280-2. PMID: 11771020. / https://doi.org/10.2310/7070.2001.19532
Choi JY, Kim JH, Kim HJ, Glasauer S, Kim JS. Central paroxysmal positional nystagmus: Characteristics and possible mechanisms. Neurology. 2015 2;84(22):2238-46. PMID: 25957336. / https://doi.org/10.1212/WNL.0000000000001640
Comisión de Otoneurología de la Sociedad Otorrinolaringológica de Castilla y León, Cantabria y La Rioja. Espa-a. Guía práctica del vértigo posicional paroxístico benigno. Rev. ORL, 2017, 8, 3, pp. 157-196.
Dix MR, Hallpike CS. The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol. 1952;61(4):987-1016. PMID: 13008328. / https://doi.org/10.1177/000348945206100403
Drachman DA, Diamond ER, Hart CW. Posturally-evoked vomiting; Association with posterior fossa lesions. Ann Otol Rhinol Laryngol. 1977;86(1 Pt 1):97-101. PMID: 189665. / https://doi.org/10.1177/000348947708600117
Franco-Gutiérrez V, Pérez-Vázquez P. Vértigo y nistagmo posicional por etanol. Mecanismo de flotación cupular. Rev Soc Otorrinolaringol Castilla Leon Cantab La Rioja. 2013;4(4):14-20.
Kaski D. Central positional vertigo. En: De Stefano A, Dispenza F: Understanding benign paroxysmal positional vertigo. Jaypee Brothers Medical Publishers. 1ª Ed. 2017. Cap. 4; pp.64-71.
Leigh RJ, Zee DS. The neurology of eye movements. Oxford University Press. 4ª Ed. 2006. Cap. 11; pp.559-97.
Lin J, Elidan J, Baloh RW, Honrubia V. Direction-changing positional nystagmus: incidence and meaning. Am J Otolaryngol. 1986;7(4):306-10. PMID: 3489418. / https://doi.org/10.1016/S0196-0709(86)80054-0
McAuley JR, Dickman JD, Mustain W, Anand VK. Positional nystagmus in asymptomatic human subjects. Otolaryngol Head Neck Surg. 1996;114(4):545-53. PMID: 8643263. / https://doi.org/10.1016/S0194-5998(96)70245-0
Nylén CO. Positional nystagmus; a review and future prospects. J Laryngol Otol. 1950;64(6):295-318. PMID: 15428772. / https://doi.org/10.1017/S0022215100012123
Pérez-Fernández N, Cervera-Paz FJ. Otras exploraciones del sistema vestibular. En: Bartual-Pastor J, Pérez-Fernández N: El sistema vestibular y sus alteraciones. Tomo I: Fundamentos y semiología. Masson, S.A. 1ª Ed. 1998. Cap. 15; pp.239-255.
Roberts RA, Gans RE. Background, technique, interpretation and uselfulness of positional/positioning testing. En: Jacobson GP, Shepard NT: Balance function assessment and management. Plural Publishing. 2008. 1ª Ed. Cap. 9;pp.171-196.
Sanz-Fernández R, Martín-Sanz E. Exploración Otoneurológica. Amplifon Ibérica. 1ª Ed. 2016. pp.336.
Sauvage JP. Vértigos: manual de diagnóstico y rehabilitación. Elsevier Espa-a. 2ª Ed. 2014. Cap. 5; pp.35-52.
Baloh RW, Kerber KA. Clinical neurophysiology of the vestibular system. Oxford University Press. 4ª Ed. 2011. Cap. 6; pp.149-170.
Barber HO. Positional nystagmus. Otolaryngol Head Neck Surg. 1984;92(6):649-55. PMID: 6440083 / https://doi.org/10.1177/019459988409200611
Bertholon P, Tringali S, Faye MB, Antoine JC, Martin C. Prospective study of positional nystagmus in 100 consecutive patients. Ann Otol Rhinol Laryngol. 2006;115(8):587-94. PMID: 16944657. / https://doi.org/10.1177/000348940611500804
Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE. Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res. 2009;19(1-2):1-13. doi: 10.3233/VES-2009-0343. PMID: 19893191.
Bisdorff AR, Staab JP, Newman-Toker DE. Overview of the International Classification of Vestibular Disorders. Neurol Clin. 2015;33(3):541-50, vii. doi: 10.1016/j.ncl.2015.04.010. Review. PMID: 26231270. / https://doi.org/10.1016/j.ncl.2015.04.010
Brandt T. Positional and positioning vertigo and nystagmus. J Neurol Sci. 1990;95(1):3-28. PMID: 2187057. / https://doi.org/10.1016/0022-510X(90)90113-2
Bronstein A, Lempert T. Dizziness. Cambridge University Press. 1ª Ed. 2007. Cap. 5; pp.131-156.
Chang MB, Bath AP, Rutka JA. Are all atypical positional nystagmus patterns reflective of central pathology?. J Otolaryngol. 2001;30(5):280-2. PMID: 11771020. / https://doi.org/10.2310/7070.2001.19532
Choi JY, Kim JH, Kim HJ, Glasauer S, Kim JS. Central paroxysmal positional nystagmus: Characteristics and possible mechanisms. Neurology. 2015 2;84(22):2238-46. PMID: 25957336. / https://doi.org/10.1212/WNL.0000000000001640
Comisión de Otoneurología de la Sociedad Otorrinolaringológica de Castilla y León, Cantabria y La Rioja. Espa-a. Guía práctica del vértigo posicional paroxístico benigno. Rev. ORL, 2017, 8, 3, pp. 157-196.
Dix MR, Hallpike CS. The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol. 1952;61(4):987-1016. PMID: 13008328. / https://doi.org/10.1177/000348945206100403
Drachman DA, Diamond ER, Hart CW. Posturally-evoked vomiting; Association with posterior fossa lesions. Ann Otol Rhinol Laryngol. 1977;86(1 Pt 1):97-101. PMID: 189665. / https://doi.org/10.1177/000348947708600117
Franco-Gutiérrez V, Pérez-Vázquez P. Vértigo y nistagmo posicional por etanol. Mecanismo de flotación cupular. Rev Soc Otorrinolaringol Castilla Leon Cantab La Rioja. 2013;4(4):14-20.
Kaski D. Central positional vertigo. En: De Stefano A, Dispenza F: Understanding benign paroxysmal positional vertigo. Jaypee Brothers Medical Publishers. 1ª Ed. 2017. Cap. 4; pp.64-71.
Leigh RJ, Zee DS. The neurology of eye movements. Oxford University Press. 4ª Ed. 2006. Cap. 11; pp.559-97.
Lin J, Elidan J, Baloh RW, Honrubia V. Direction-changing positional nystagmus: incidence and meaning. Am J Otolaryngol. 1986;7(4):306-10. PMID: 3489418. / https://doi.org/10.1016/S0196-0709(86)80054-0
McAuley JR, Dickman JD, Mustain W, Anand VK. Positional nystagmus in asymptomatic human subjects. Otolaryngol Head Neck Surg. 1996;114(4):545-53. PMID: 8643263. / https://doi.org/10.1016/S0194-5998(96)70245-0
Nylén CO. Positional nystagmus; a review and future prospects. J Laryngol Otol. 1950;64(6):295-318. PMID: 15428772. / https://doi.org/10.1017/S0022215100012123
Pérez-Fernández N, Cervera-Paz FJ. Otras exploraciones del sistema vestibular. En: Bartual-Pastor J, Pérez-Fernández N: El sistema vestibular y sus alteraciones. Tomo I: Fundamentos y semiología. Masson, S.A. 1ª Ed. 1998. Cap. 15; pp.239-255.
Roberts RA, Gans RE. Background, technique, interpretation and uselfulness of positional/positioning testing. En: Jacobson GP, Shepard NT: Balance function assessment and management. Plural Publishing. 2008. 1ª Ed. Cap. 9;pp.171-196.
Sanz-Fernández R, Martín-Sanz E. Exploración Otoneurológica. Amplifon Ibérica. 1ª Ed. 2016. pp.336.
Sauvage JP. Vértigos: manual de diagnóstico y rehabilitación. Elsevier Espa-a. 2ª Ed. 2014. Cap. 5; pp.35-52.
Benito-Orejas, J. I., Valda-Rodrigo, J., & Alonso-vielba-varea, J. (2017). Review of Positional Nystagmus. Revista ORL, 9(2), 105–110. https://doi.org/10.14201/orl.17190
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