A new method for evaluating lateral semicircular canal cupulopathy

Abstract

4.

Direction-reversing Nystagmus in Horizontal and Posterior Semicircular Canal Canalolithiasis

“…We also excluded BPPV patients with multiple canal involvement and those with HSCC BPPV who exhibited both canalolithiasis and cupulolithiasis. Coexistence of HSCC cupulolithiasis was determined by persistent apogeotropic nystagmus in a supine roll test with identification of a null plane (5,6). Thorough neurologic examination did not detect any focal neurologic deficit in any of the patients.…”

Positional Vertigo Showing Direction-Changing Positional Nystagmus after Chronic Otitis Media Surgery: Is It Benign Paroxysmal Positional Vertigo?

“…It has been pointed out that determination of the duration of DCPN and identification of a null plane are important in a differential diagnosis between hSCC canalolithiasis and light cupula[6,7]. Because our patient showed persistent geotropic DCPN with a null plane on the operated side, the authors thinkthat the condition of light cupula is responsible for the positional vertigo in this patient.…”

“…2C, D; Supplementary video clip 1). A null plane, at which nystagmus ceases and the direction of nystagmus changes by further rotation [6,7], was identified when the…”

Sudden sensorineural hearing loss with positional vertigo: Initial findings of positional nystagmus and hearing outcomes

“…Among 26 patients assessed for a null plane (17 of 28 patients with persistent geotropic DCPN and all nine patients with persistent apogeotropic DCPN), we identified the null plane on the same side as the SSNHL in 13 (of 17, 76%) and five patients (of 9, 56%) with persistent geotropic and apogeotropic DCPN, respectively ( Figure 1). The null plane was identified on the opposite side of the SSNHL in 24% (4 of 17) and 44% (4 of 9) of patients with persistent geotropic and apogeotropic DCPN, respectively, even though a null plane is reportedly found on the affected side in most cases of cupulopathy (Bisdorff & Debatisse, 2001;Kim et al, 2015;Shin et al, 2015).…”

“…The concept of a light cupula was recently introduced to explain persistent geotropic DCPN (Hiruma & Numata, 2004;Bergenius & Tomanovic, 2006;Ichijo, 2012;Kim et al, 2014b). Considering that persistent DCPN develops due to the cupulopathy, a null plane, at which the nystagmus ceases, can be identified (Bisdorff & Debatisse, 2001;Kim et al, 2015). Among 26 patients assessed for a null plane (17 of 28 patients with persistent geotropic DCPN and all nine patients with persistent apogeotropic DCPN), we identified the null plane on the same side as the SSNHL in 13 (of 17, 76%) and five patients (of 9, 56%) with persistent geotropic and apogeotropic DCPN, respectively ( Figure 1).…”