Skip to main content Accessibility help
×
Home

Posterior semicircular canal paroxysmal positional vertigo triggers a new type of windmill nystagmus

  • F Comacchio (a1), N Cutrì (a2) and M Mion (a3)

Abstract

Background

Periodic alternating nystagmus is a rare condition characterised by spontaneous horizontal nystagmus that periodically reverses direction, indicating an alteration of the velocity storage mechanism. Windmill nystagmus is a peculiar and rare variant of periodic alternating horizontal nystagmus with a superimposed periodic alternating vertical nystagmus. It is generally observed in blind patients.

Case report

This paper presents the unique case of a normally sighted patient with a windmill nystagmus triggered by an episode of benign paroxysmal positional vertigo due to bilateral posterior canalolithiasis. Videonystagmography revealed an anticlockwise up-beating nystagmus followed by a clockwise down-beating nystagmus with a cycle lasting 2 minutes, followed by a brief burst of horizontal left-beating nystagmus.

Conclusion

This case report represents the first observation of a new type of windmill nystagmus, probably provoked by a malfunction of the velocity storage mechanism, gaze-stabilisation and short-adaptation networks, with a loss of cerebellar inhibition.

Copyright

Corresponding author

Author for correspondence: Dr Marta Mion, Institute of Otolaryngology, Department of Neurosciences, University of Padua, Via Nicolò Giustiniani 2, 35121Padua, Italy E-mail: med.mion@gmail.com

Footnotes

Hide All

Dr M Mion takes responsibility for the integrity of the content of the paper

Footnotes

References

Hide All
1Choi, KD, Shin, HK, Kim, JS, Kim, SH, Choi, JH, Kim, HJ et al. Variants of windmill nystagmus. J Neurol 2016;263(suppl 7):1375–81
2Sanders, MD, Glaser, JS. Alternating windmill nystagmus. In: Smith, JL, ed. Neuro-ophthalmology. St Louis: Mosby, 1973;133–6
3Lee, SU, Jo, SY, Kim, HJ, Choi, JY, Kim, JS. Windmill nystagmus in a patient with subacute visual loss. J Neurol 2018;265(suppl 11):2737–9
4Robinson, DA. The use of control system analysis in the neurophysiology of eye movements. Ann Rev Neurosci 1981;4:463503
5Dow, ER, Anastasio, TJ. Instabilities in eye movement control: a model of periodic alternating nystagmus. In: Jordan, MI, Kearns, MJ, Solla, SA, eds. Advances in Neural Information Processing Systems 10. Cambridge, MA: MIT Press, 1998;138–44
6Yakushin, SB, Raphan, T, Cohen, B. Coding of velocity storage in the vestibular nuclei. Front Neurol 2017;8:386
7Bertolini, G, Bockisch, CJ, Straumann, D, Zee, DS, Ramat, S. Do humans show velocity-storage in the vertical rVOR? Prog Brain Res 2008;171:207–10
8Raphan, T, Cohen, B. Organizational principles of velocity storage in three dimensions: the effect of gravity on cross-coupling of optokinetic after-nystagmus. Ann N Y Acad Sci 1988;545:7492
9Chiu, B, Hain, TC. Periodic alternating nystagmus provoked by an attack of Meniere's disease. J Neuroophthalmol 2002;22:107–9
10Murofushi, T, Chihara, Y, Ushio, M, Iwasaki, S. Periodic alternating nystagmus in Meniere's disease: the peripheral type? Acta Otolaryngol 2008;128:824–7
11Kim, SH, Chung, WK, Kim, BG, Hwang, CS, Kim, MJ, Lee, WS. Periodic alternating nystagmus of peripheral vestibular origin. Laryngoscope 2014;124(suppl 4):980–3
12Daroff, RB, Dell'Osso, LF. Periodic alternating nystagmus and the shifting null. Can J Otolaryngol 1974;3(suppl 3):367–71

Keywords

Type Description Title
VIDEO
Supplementary materials

Comacchio et al. supplementary material
Comacchio et al. supplementary material 1

 Video (15.2 MB)
15.2 MB
VIDEO
Supplementary materials

Comacchio et al. supplementary material
Comacchio et al. supplementary material 2

 Video (138.3 MB)
138.3 MB

Posterior semicircular canal paroxysmal positional vertigo triggers a new type of windmill nystagmus

  • F Comacchio (a1), N Cutrì (a2) and M Mion (a3)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed