Male Amanda J, Korres George, Koohi Nehzat, Kaski Diego
SENSE Research Unit, Department of Clinical and Movements Neurosciences, UCL Institute of Neurology, 33 Queen Square, London, WC1N 3BG, UK.
Department of ENT/Neuro-Otology, Attikon University Hospital, Athens, Greece.
J Neurol. 2025 Sep 5;272(9):615. doi: 10.1007/s00415-025-13335-2.
Positional nystagmus is a frequently encountered yet often underappreciated clinical sign that provides critical insights into vestibular and central nervous system function. For the general neurologist, recognising and correctly interpreting positional nystagmus can significantly impact diagnostic accuracy and guide appropriate management of common and complex dizziness presentations. The current diagnostic framework for positional nystagmus disproportionately favours BPPV, underestimates central positional nystagmus (CPN), and over-relies on imaging. We argue for a paradigm shift that acknowledges clinical complexity, defines objective diagnostic thresholds, and strengthens neurological training.
位置性眼球震颤是一种常见但常被忽视的临床体征，能为前庭和中枢神经系统功能提供关键见解。对于普通神经科医生而言，识别并正确解释位置性眼球震颤可显著影响诊断准确性，并指导对常见及复杂头晕症状的恰当处理。当前位置性眼球震颤的诊断框架过度偏向于良性阵发性位置性眩晕（BPPV），低估了中枢性位置性眼球震颤（CPN），且过度依赖影像学检查。我们主张进行范式转变，承认临床复杂性，定义客观诊断阈值，并加强神经学培训。
