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

Published online by Cambridge University Press:  17 December 2019

F Comacchio ,
N Cutrì  and
M Mion
F Comacchio
Affiliation:
Regional Specialized Vertigo Center, Institute of Otolaryngology, Department of Neurosciences, University of Padua, Italy
N Cutrì
Affiliation:
Otolaryngology Ambulatorial Service, Socio Sanitary District, Padua, Italy
M Mion*
Affiliation:
Institute of Otolaryngology, Department of Neurosciences, University of Padua, Italy
*
Author for correspondence: Dr Marta Mion, Institute of Otolaryngology, Department of Neurosciences, University of Padua, Via Nicolò Giustiniani 2, 35121 Padua, Italy E-mail: med.mion@gmail.com
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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.

Keywords

Benign Paroxysmal Positional VertigoCerebellumOtoliths

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 1 , January 2020 , pp. 86 - 89
Copyright
Copyright © JLO (1984) Limited, 2019

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Footnotes

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

References

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