Published online Nov 6, 2022. doi: 10.12998/wjcc.v10.i31.11625
Peer-review started: July 20, 2022
First decision: August 4, 2022
Revised: August 15, 2022
Accepted: September 22, 2022
Article in press: September 22, 2022
Published online: November 6, 2022
Processing time: 99 Days and 0.9 Hours
Benign paroxysmal positional vertigo (BPPV) is a form of temporary vertigo induced by moving the head to a specific position. It is a self-limited, peripheral, vestibular disease and can be divided into primary and secondary forms. Congenital nystagmus (CN), an involuntary, rhythmic, binocular-symmetry, conjugated eye movement, is found at birth or within 3 mo of birth. According to the pathogenesis, CN can be divided into sensory-defect nystagmus and motor-defect nystagmus. The coexistence of BPPV and CN is rarely seen in the clinic.
A 62-year-old woman presented to our clinic complaining of a 15-d history of recurrent positional vertigo. The vertigo lasting less than 1 min occurred when she turned over, sometimes accompanied by nausea and vomiting. Both the patient and her father had CN. Her spontaneous nystagmus was horizontal to right; however, the gaze test revealed variable horizontal nystagmus with the same degree when the eyes moved. The patient’s Dix-Hallpike test was normal, except for persistent nystagmus, and the roll test showed severe variable horizontal nystagmus, which lasted for about 20 s in the same direction as her head movement to the right and left, although the right-side nystagmus was stronger than the left-side. Since these symptoms were accompanied by nausea, she was diagnosed with BPPV with CN and treated by manual reduction.
Though rare, if BPPV with CN is correctly identified and diagnosed, reduction treatment is comparably effective to other vertigo types.
Core Tip: Benign paroxysmal positional vertigo (BPPV) is defined as a disorder of the inner ear characterized by repeated episodes of positional vertigo. Congenital nystagmus (CN), an involuntary, rhythmic, binocular-symmetry, conjugated eye movement, is found at birth or within 3 mo of birth. BPPV with CN is rarely seen in the clinic. CN should be distinguished from other pathologic nystagmus types. BPPV can be accurately determined through postural nystagmus. We report the characteristics of BPPV with CN, further explaining how to identify nystagmus.