When paroxysmal positioning vertigo isn't benign

J Am Acad Audiol. 1995 Jul;6(4):346-9.

Abstract

The electronystagmographic auditory brainstem response and magnetic resonance imaging findings for a 33-year-old male with a 3.5 cm left vestibular schwannoma are presented. Of particular interest was the presence of an unusual positioning nystagmus following the Dix-Hallpike maneuver in the right head-hanging position. The patient demonstrated a nystagmus that was immediate in onset and not fatigueable upon repeated positioning. During positioning, the patient experienced a vertical bobbing sensation and dysphoria, but not rotational vertigo. Most importantly, the nystagmus had a predominant downbeating vertical component. the case illustrates the diagnostic significance of downbeating nystagmus elicited by the Dix-Hallpike maneuver.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Audiometry
  • Electronystagmography
  • Functional Laterality
  • Hearing Loss, Sensorineural / diagnosis
  • Hearing Loss, Sensorineural / physiopathology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Neuroma, Acoustic / complications
  • Neuroma, Acoustic / diagnosis
  • Neuroma, Acoustic / pathology
  • Nystagmus, Pathologic
  • Vertigo / diagnosis*
  • Vertigo / etiology
  • Vestibulocochlear Nerve / pathology