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Periodic alternating nystagmus of peripheral vestibular origin

Authors
 Sung H. Kim  ;  Woon-Kyo Chung  ;  Bo G. Kim  ;  Chi S. Hwang  ;  Mi J. Kim  ;  Won-Sang Lee 
Citation
 Laryngoscope, Vol.124(4) : 980-983, 2014 
Journal Title
 Laryngoscope 
ISSN
 0023-852X 
Issue Date
2014
Abstract
OBJECTIVES/HYPOTHESIS: Periodic alternating nystagmus (PAN) is most commonly found either in its congenital form or after cerebellar/pontomedullary lesions. However, we identified PAN in 10 patients with peripheral vestibular disorders and will try to describe their characteristics to aid in the differential diagnosis between peripheral and central etiologies. STUDY DESIGN: Observation of a case series. METHOD: Peripheral vestibular lesions were confirmed by neurological examinations, vestibular function tests, and brain magnetic resonance imaging (MRIs). Eye movements of the patients were recorded using electronystagmography or video nystagmography for a minimum of 10 minutes to confirm the nystagmus change in direction. RESULTS: The final diagnoses of the patients included Meniere's disease (n = 3), acute labyrinthitis (n = 4), sudden sensorineural hearing loss with vertigo (n = 2), and vestibular schwannoma (n = 1). Direction-changing spontaneous horizontal nystagmus with quiescent intervals was observed in all patients under dark conditions. The nystagmus was suppressed by visual fixation; and the results of oculomotor tests were normal for saccadic and smooth pursuit eye movements and optokinetic nystagmus. All patients showed mild to complete canal paresis on a bithermal caloric test. PAN progressed into unidirectional nystagmus of the contra-lesion side in all patients within 48 hours. CONCLUSION: PAN can be observed in patients with peripheral vestibular disorders, but detecting PAN in this subpopulation is difficult because of its transitory nature. The absence of central symptoms and signs, the visual suppression of PA
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/lary.24355/abstract
DOI
10.1002/lary.24355
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Huhn(김성헌)
Lee, Won Sang(이원상)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98461
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