• Research in Vestibular Science
• /
• v.17 no.4
• /
• pp.167-169
• /
• 2018

Rotatory vertebral artery syndrome (RVAS) is characterized by recurrent attacks of vertigo, nystagmus, and syncope induced by compression of the vertebral artery during head rotation. A 60-year-old man with atlas vertebrae fracture presented recurrent attacks of positional vertigo. Left-beat, upbeat and count clock-wise torsional nystagmus occurred after lying down and bilateral head roll (HR) showing no latency or fatigue. Magnetic resonance imaging revealed foramen magnum stenosis (FMS) and dominancy of right vertebral artery (VA). The flow of the right VA on transcranial Doppler decreased significantly during left HR. The slower the velocity was, the more the nystagmus was aggravated. RVAS can be evoked by FMS causing compression of the VA. And the nystagmus might be aggravated according to the blood flow insufficiency.

• Annals of Clinical Neurophysiology
• /
• v.25 no.1
• /
• pp.10-18
• /
• 2023

The ultimate purpose of eye movement is to maintain clear vision by ensuring that images of observed objects are focused on the fovea in the retina. Accurate evaluation of ocular movements, including nystagmus and saccadic intrusions, provides very useful information for determining the overall function and abnormality of the complex oculomotor system, from the peripheral vestibular system to the cerebrum. Eye movement tests are therefore essential for the accurate diagnosis of patients who complain of dizziness and imbalance. They help to predict lesion locations from the peripheral vestibular system to the central cerebral cortex and play an important role in differentiation from other diseases. The methodology of recording and interpreting ocular movements using video-oculography are described in this review article.

• Journal of Medicine and Life Science
• /
• v.16 no.3
• /
• pp.64-75
• /
• 2019

Vertigo and dizziness are common symptoms with various etiologies and pathogeneses. Vertigo is an illusion of motion due to disease of the vestibular system, usually a sense of rotation. Dizziness, a term that represents a wide range of non-vertigo symptoms, is commonly associated with non-vestibular disorders including old age, cardiac syncope, orthostatic hypotension, metabolic disease, anxiety, and drugs. Vertigo should be determined whether the cause is central or peripheral. Peripheral vertigo is usually benign but central vertigo is serious and often require urgent treatment. The careful history and detailed physical examinations(pattern of nystagmus, ocular tilt reaction, head impulse test and positional tests such as Dix-Hallpike maneuver) provide important clues to the diagnosis of vertigo. Most of patients have benign peripheral vestibular disorders - vestibular neuritis, benign paroxysmal positional vertigo (BPPV), and Meniere's disease. BPPV is a leading cause of peripheral vertigo and can easily be cured with a canalith repositioning maneuver. In this review, a focus is on the differential diagnosis of common vestibular disorders with peripheral and central causes.