Cupulolithiasis as an Alternative Mechanism for Pseudo-spontaneous Nystagmus in Horizontal Canal Benign Paroxysmal Positional Vertigo

Felix K Schwarz; Erich Vyskocil; Bela Büki; Gerald Wiest

doi:10.1177/2473974X221089847

Cupulolithiasis as an Alternative Mechanism for Pseudo-spontaneous Nystagmus in Horizontal Canal Benign Paroxysmal Positional Vertigo

OTO Open. 2022 Mar 29;6(1):2473974X221089847. doi: 10.1177/2473974X221089847. eCollection 2022 Jan-Mar.

Authors

Felix K Schwarz¹, Erich Vyskocil², Bela Büki³, Gerald Wiest¹

Affiliations

¹ Department of Neurology, Medical University of Vienna, Vienna, Austria.
² Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
³ Department of Otolaryngology, Karl Landsteiner University Hospital, Krems, Austria.

Abstract

Benign paroxysmal positional vertigo of the horizontal semicircular canal may present a differential diagnostic challenge. In addition to the classical positional nystagmus, a persistent nystagmus in a seated position occasionally occurs, so-called pseudo-spontaneous nystagmus (PSN), which can be mistaken for a central or peripheral spontaneous nystagmus. We report a case with cupulolithiasis of the horizontal semicircular canal presenting with horizontal PSN in a sitting position, with implications for a new pathomechanism of PSN.

Keywords: benign paroxysmal positional vertigo; cupulolithiasis; horizontal semicircular canal; pseudo-spontaneous nystagmus.

Publication types

Case Reports