Lin J, Elidan J, Baloh R W, Honrubia V
Am J Otolaryngol. 1986 Jul-Aug;7(4):306-10. doi: 10.1016/s0196-0709(86)80054-0.
Direction-changing positional nystagmus (DCPN) is a nystagmus that changes its direction with different body and head positions. Many authors consider that it indicates the presence of a central nervous system lesion. Of 1,196 patients whose abnormal electronystagmographic (ENG) traces were reviewed, 46 (3.8 per cent) showed DCPN. Of these, ten (22 per cent) had central neurologic diseases, 14 (30 per cent) had peripheral vestibular diseases, and for 22 (48 per cent) there was no definite clinical diagnosis. Nineteen patients (41 per cent) with DCPN had ENG findings suggesting a peripheral vestibular lesion, while only five (11 per cent) had ENG findings suggesting a central vestibular lesion. Four of 44 control subjects exhibited DCPN. Thus, the presence of DCPN does not necessarily indicate disease of the vestibular system and definitely does not localize the site of a lesion in the vestibular pathways, but more often indicates a peripheral vestibular site. As with spontaneous nystagmus, lack of suppression with fixation suggests a central lesion.
变向性位置性眼球震颤（DCPN）是一种随身体和头部位置不同而改变方向的眼球震颤。许多作者认为它提示存在中枢神经系统病变。在1196例经回顾其异常眼震电图（ENG）记录的患者中，46例（3.8%）表现为DCPN。其中，10例（22%）患有中枢神经系统疾病，14例（30%）患有外周前庭疾病，22例（48%）没有明确的临床诊断。19例（41%）患有DCPN的患者其ENG结果提示外周前庭病变，而只有5例（11%）的ENG结果提示中枢前庭病变。44名对照受试者中有4例出现DCPN。因此，DCPN的存在不一定表明前庭系统疾病，肯定不能定位前庭通路中的病变部位，但更常见的是提示外周前庭部位。与自发性眼球震颤一样，注视时不被抑制提示中枢病变。
