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The Light Cupula: An Emerging New Concept for Positional Vertigo

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초록

Benign paroxysmal positional vertigo (BPPV) is the most common type of positional vertigo. A canalolithiasis-type of BPPV involving the lateral semicircular canal (LSCC) shows a characteristicdirection-changing positional nystagmus (DCPN) which beats towards the lower ear(geotropic) on turning the head to either side in a supine position. Because geotropic DCPN inLSCC canalolithiasis is transient with a latency of a few seconds, the diagnosis can be challengingif geotropic DCPN is persistent without latency. The concept of “light cupula” hasbeen introduced to explain persistent geotropic DCPN, although the mechanism behind itrequires further elucidation. In this review, we describe the characteristics of the nystagmicpattern in light cupula and discuss the current evidence for possible mechanisms explainingthe phenomenon.

Abstract

Benign paroxysmal positional vertigo (BPPV) is the most common type of positional vertigo. A canalolithiasis-type of BPPV involving the lateral semicircular canal (LSCC) shows a characteristicdirection-changing positional nystagmus (DCPN) which beats towards the lower ear(geotropic) on turning the head to either side in a supine position. Because geotropic DCPN inLSCC canalolithiasis is transient with a latency of a few seconds, the diagnosis can be challengingif geotropic DCPN is persistent without latency. The concept of “light cupula” hasbeen introduced to explain persistent geotropic DCPN, although the mechanism behind itrequires further elucidation. In this review, we describe the characteristics of the nystagmicpattern in light cupula and discuss the current evidence for possible mechanisms explainingthe phenomenon.

참고문헌 (30)

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