VIDEO – PC-BPPV Nystagmus: It’s not so rotary after all
Published on: September 6, 2013
In this video we see a strong and clear nystagmus consistent with a right ear (PC-BPPV Nystagmus: It’s not so rotary after all) PC-BPPV. The nystagmus, while described as “rotary-torsional”, will actually have a more visible upward and oblique movement than may be anticipated by new practitioners.
Often times, practitioners new to BPPV are perplexed when they begin see their first PC-BPPV patients after learning in their lectures about “rotary-torsional” nystagmus. It is important to remember Ewald’s 1st Law. Simply put, vertical canal BPPV produces vertical nystagmus. Posterior canal is upbeat, anterior canal (rare) downbeat, both with an oblique “twist” toward the ground. Also worth considering is the varying viscoelastic properties of the extra-ocular muscles. The rectus muscles are larger and stronger and the obliques, smaller and weaker. This often causes an earlier fatigue of the “rotary” aspect of the nystagmus but leaving the vertical component, which is rectus, dominated.
For a comprehensive discussion of eye movement, corresponding muscles and canal involvement see Roberts and Gans, Chapter 9, In Jacobson and Shephard (Eds.), Balance Function Assessment and Management, Plural, 2008.
Fall Risk Management in Audiology and ENT Practice: The Role of Cognitive, Vestibular, and Auditory Function
Published on: February 24, 2023
Patient Care // Fall Risk Management | March 2023 Hearing Review There is significant multidisciplinary interest in modifying risk factors for falling in the population of older adults. By Joseph […]
Part 3 – Audiovestibular Migraine What Audiologists and ENTs Need to Know in 2022 for Expanding Patient Care
Published on: December 13, 2022
Tech Topic | December 2022 Hearing Review Millions of patients needlessly go without proper diagnosis and treatment each year. It is the authors’ hope that readers will become more interested […]
Part 2 – Audiovestibular Symptoms Related to Migraine – What Audiologists and ENTs Need to Know in 2022 for Expanding Patient Care
Published on: November 7, 2022
Tech Topic | November 2022 Hearing Review One of the greatest challenges in the evaluation and management of patients with migraine is the diversity in the presentation of symptoms among […]
Part 1 – Audiovestibular Symptoms Related to Migraine – What Audiologists and ENTs Need to Know In 2022 For Expanding Patient Care
Published on: October 14, 2022
Patient Care | October 2022 Hearing Review Migraine affects nearly 40 million individuals in the United States, more than asthma and diabetes combined. Most will have dizziness, vertigo, misophonia, and […]