Head-Jolting Nystagmus Occlusion of the Horizontal Semicircular Canal Induced by Vigorous Head Shaking
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Importance: We report a new syndrome, which we are calling head-jolting nystagmus, that expands the differential diagnosis of head movement–induced paroxysmal vertigo.
Observations: Two male patients (65 and 58 years old) described rotational vertigo after violent and brief (1- to 2-second) oscillations of the head (head jolting) that triggered intense horizontal nystagmus lasting 45 seconds. Accelerations of the head required to induce these episodes could only be achieved by the patients themselves. In case 1, the episodes gradually disappeared over a 6-year period. In case 2, magnetic resonance imaging (3-T) suggested a filling defect within the left horizontal semicircular canal. He underwent surgical canal plugging in March 2013 that resolved the symptoms.
Conclusions and Relevance: We attribute head-jolting nystagmus to dislodged material within the horizontal semicircular canal and provide a mechanistic model to explain its origin.
Observations: Two male patients (65 and 58 years old) described rotational vertigo after violent and brief (1- to 2-second) oscillations of the head (head jolting) that triggered intense horizontal nystagmus lasting 45 seconds. Accelerations of the head required to induce these episodes could only be achieved by the patients themselves. In case 1, the episodes gradually disappeared over a 6-year period. In case 2, magnetic resonance imaging (3-T) suggested a filling defect within the left horizontal semicircular canal. He underwent surgical canal plugging in March 2013 that resolved the symptoms.
Conclusions and Relevance: We attribute head-jolting nystagmus to dislodged material within the horizontal semicircular canal and provide a mechanistic model to explain its origin.
Date Issued
2015-05-21
Date Acceptance
2015-01-12
Citation
JAMA Otolaryngology-Head and Neck Surgery, 2015, 141 (8), pp.757-760
ISSN
2168-6181
Publisher
American Medical Association
Start Page
757
End Page
760
Journal / Book Title
JAMA Otolaryngology-Head and Neck Surgery
Volume
141
Issue
8
Copyright Statement
© 2015 American Medical Association. All rights reserved.
Sponsor
Medical Research Council (MRC)
Medical Research Council (MRC)
Imperial College Healthcare NHS Trust- BRC Funding
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000361056100015&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
G0600183
MR/J004685/1
RDC04 79560
Subjects
Science & Technology
Life Sciences & Biomedicine
Otorhinolaryngology
Surgery
PAROXYSMAL POSITIONAL VERTIGO
VESTIBULAR PAROXYSMIA
Aged
Benign Paroxysmal Positional Vertigo
Head Movements
Humans
Male
Middle Aged
Nystagmus, Pathologic
Semicircular Canals
Syndrome
Publication Status
Published