Case Report: Keep your eyes open! Nystagmus guides atypical BPPV

Daniel Ludwig; Michael C Schubert

doi:10.3389/fresc.2024.1384151

Case Report: Keep your eyes open! Nystagmus guides atypical BPPV

Front Rehabil Sci. 2024 Mar 28:5:1384151. doi: 10.3389/fresc.2024.1384151. eCollection 2024.

Authors

Daniel Ludwig¹, Michael C Schubert^{1

2}

Affiliations

¹ Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States.
² Laboratory of Vestibular NeuroAdaptation, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, United States.

Abstract

The clinical diagnosis of benign paroxysmal positional vertigo (BPPV) is confirmed from observing the direction, intensity, and duration of nystagmus from unique head positions that advantage gravity to overcome the inertia of otoconia displaced inside the semicircular canals. This case series highlights BPPV with atypical nystagmus presentations relative to the head position. Clinicians should carefully observe symptoms and nystagmus presentations regardless of the testing position and utilize technology and rules of vestibular physiology to enhance their diagnostic acumen.

Keywords: BPPV; atypical; positional nystagmus; positional vertigo; vestibular.

Publication types

Case Reports

Grants and funding

The authors declare that no financial support was received for the research, authorship, and/or publication of this article.