Regional Specialized Vertigo Center Veneto Region.
Otolaryngology Unit, St. Anthony Hospital.
Otol Neurotol. 2018 Oct;39(9):e843-e848. doi: 10.1097/MAO.0000000000001949.
Canalith jam refers to a condition caused by an otolithic clump blocked inside a semicircular canal, generally provoked by canalith repositioning procedure. We describe the first case of spontaneous canalith jam mimicking an acute vestibular deficit.
We report the case of an 82-year-old woman who suffered a sudden episode of persistent rotational vertigo with nausea and vomiting, not provoked by head movements.
Videonystagmography revealed a horizontal right-beating spontaneous nystagmus, inhibited by visual fixation. Surprisingly, the positional test showed a direction changing apogeotropic horizontal nystagmus weaker in the left side, compatible with a left side horizontal canal canalolithiasis of the apogetropic type. Returning to the sitting position, a spontaneous nystagmus was observed again, not tilt sensitive. A left side caloric paresis was found.
After performing liberatory maneuvers, the spontaneous nystagmus disappeared and a horizontal canal benign paroxysmal positional vertigo of geotropic type was documented. The canal paresis also disappeared.
Canalith jam is rarely described and is overall observed as a repositioning manoeuvre complication, not as a mimicker of a vestibular neuritis. Furthermore, our case represents the first observation of a recurrent canalith jam and apogeotropic variant of horizontal canal benign paroxysmal positional vertigo.
耳石结是指由于耳石块阻塞在半规管内而引起的一种情况，通常由耳石复位程序引起。我们描述了首例自发性耳石结模拟急性前庭功能减退的病例。
我们报告了一例 82 岁女性的病例，她突然出现持续性旋转性眩晕，伴有恶心和呕吐，但没有头部运动诱发。
视频眼震图显示右侧水平方向的自发性眼震，视觉固视可抑制。令人惊讶的是，位置试验显示左侧水平半规管向位性耳石症的方向变化性向位性水平眼震，左侧水平半规管向位性耳石症的类型较弱。回到坐姿时，再次观察到自发性眼震，但不受倾斜敏感。发现左侧冷刺激减弱。
进行松解手法后，自发性眼震消失，记录到水平管良性阵发性位置性眩晕向位性类型。管功能减退也消失了。
耳石结很少被描述，总体上被观察为复位操作的并发症，而不是前庭神经炎的模拟。此外，我们的病例代表了首例复发性耳石结和向位性水平管良性阵发性位置性眩晕的观察。
