Nystagmus in benign paroxysmal positional vertigo: a three-component analysis.

Three-component analysis of nystagmus was carried out in 10 patients with benign paroxysmal positional vertigo (BPPV), focusing on the horizontal, vertical and torsional components, with the aid of a computerized eye movement analysis system. Using a pendular rotation stimulus we also measured three eye components of eye movement evoked from the vertical semicircular canals in 3 normal subject; two components (vertical and torsional) of nystagmus in patients with BPPV were compared with that of eye movements derived from the vertical semicircular canals. The time course of slow phase velocity of three components in BPPV patients was similar. In BPPV, the torsional component of eye movements was larger than that of the vertical component without obvious horizontal eye deviation. On the other hand, the vertical component from vertical semicircular canals was larger than that of the torsional component. From the view point of the vestibulo-ocular reflex, it is difficult to support the idea that the pathology of BPPV is localized only to the posterior semicircular canal.