Califano L, Capparuccia P G, Di Maria D, Melillo M G, Villari G
U.O. di Otorinolaringoiatria, A. O. G. Rummo, Benevento.
Acta Otorhinolaryngol Ital. 2001 Dec;21(6):337-40.
The clinical picture of Positional Paroxysmal Vertigo (PPV) induced by vertical canal labyrintholithiasis has been clearly described, eliminating previous interpretations of pathogenesis of this disorder. The diagnosis of PPV is based on the well-known picture of positional paroxysmal Nystagmus. The Authors report a clinical sign which has not previously been reported in the literature: torsional Nystagmus induced by the Head-Shaking Test (HST). The Authors encoutered this sign in 30% of the cases of vertical canalolithiasis and in 50% of the cases diagnosed as vertical cupulolithiasis. This sign was also found in patients with a history of prior positional vertigo and in patients who, after treatment with release maneuver, no longer show clinical signs of positional vertigo. Such Nystagmus was not, however, found in the control group (normal subjects and patients suffering from other vestibular pathologies). In the present study the possible pathogenesis of this sign is discussed and some practical implications are considered.
垂直半规管耳石症诱发的位置性阵发性眩晕（PPV）的临床表现已得到清晰描述，摒弃了以往对该病症发病机制的解释。PPV的诊断基于众所周知的位置性阵发性眼球震颤表现。作者报告了一种此前文献中未报道过的临床体征：摇头试验（HST）诱发的扭转性眼球震颤。作者在30%的垂直半规管耳石症病例和50%被诊断为垂直嵴帽耳石症的病例中发现了这一体征。在有既往位置性眩晕病史的患者以及经复位手法治疗后不再表现出位置性眩晕临床体征的患者中也发现了该体征。然而，在对照组（正常受试者和患有其他前庭疾病的患者）中未发现此类眼球震颤。在本研究中，讨论了该体征可能的发病机制，并考虑了一些实际意义。
