Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, Ontario, Canada.
Laryngoscope. 2010 Jan;120(1):208-9. doi: 10.1002/lary.20730.
Vertical nystagmus occurs in patients with central vestibular system pathology. Lesions of the pons, medulla, and cerebellum lead to vertical nystagmus. Given this association, vertical nystagmus is considered pathognomonic in nature. We present a case of benign paroxysmal positional vertigo (BPPV) with positive Dix-Hallpike bilaterally, but also with upbeat purely vertical nystagmus in the straight back head hanging position. Computed tomography imaging of the typically pathologic structures in vertical nystagmus (brainstem/posterior fossa) revealed normal anatomy. We propose this case as an instance of peripheral-associated purely vertical nystagmus without central pathology, while building on our previous understanding of BPPV physiology.
垂直性眼球震颤发生于中枢前庭系统病变的患者中。脑桥、延髓和小脑的病变可导致垂直性眼球震颤。鉴于这种关联，垂直性眼球震颤被认为具有特征性。我们报告了一例良性阵发性位置性眩晕（BPPV）患者，双侧 Dix-Hallpike 试验阳性，但在直立体位头悬垂位时也出现了上跳性纯垂直性眼球震颤。对垂直性眼球震颤（脑干/后颅窝）的典型病理结构进行计算机断层扫描成像显示正常解剖结构。我们提出这个病例是外周相关的纯垂直性眼球震颤而无中枢性病变的实例，同时建立在我们对 BPPV 生理学的先前理解之上。
