Recovery Phase Spontaneous Nystagmus, Its Existence and Clinical Implication
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Background and Objectives: Determination of the lesion side based on the direction of thenystagmus could result in confusions to the clinicians due to mismatch between the vestibularfunction tests and also between vestibular and audiologic features. To minimize thesemistakes, we elucidated the clinical manifestation and vestibular function test results in caseswith recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visitedENT clinic of tertiary referral hospital for acute onset continuous vertigo from January2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo,time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each timepoint of SN, vestibular function tests and hearing function tests were performed. Results:We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated thathigh gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SNdirection and contralateral caloric weakness could indicate the recovery state of patientsand nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acutevestibulopathy patients, recovery phase nystagmus was observed and on this stage of diseasevestibular function tests shows several features that could predict recovery state.
Abstract
Background and Objectives: Determination of the lesion side based on the direction of thenystagmus could result in confusions to the clinicians due to mismatch between the vestibularfunction tests and also between vestibular and audiologic features. To minimize thesemistakes, we elucidated the clinical manifestation and vestibular function test results in caseswith recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visitedENT clinic of tertiary referral hospital for acute onset continuous vertigo from January2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo,time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each timepoint of SN, vestibular function tests and hearing function tests were performed. Results:We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated thathigh gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SNdirection and contralateral caloric weakness could indicate the recovery state of patientsand nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acutevestibulopathy patients, recovery phase nystagmus was observed and on this stage of diseasevestibular function tests shows several features that could predict recovery state.
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