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Objective: The objective of the study is to analyze and explore the characteristics of the video head impulse test (vHIT) for light cupula in the idiopathic horizontal semicircular canal and compare them with those of horizontal semicircular canal cupulolithiasis (HC-cu) in order to investigate the potential mechanism involved.
Methods: Data from 51 cases of idiopathic light cupula and 42 cases of horizontal semicircular canal cupulolithiasis were retrospectively analyzed. The positional nystagmus features, vHIT anomaly rate, gain value, saccades, and other indicators were compared. SPSS 26 and Medcalc 22 were used to analyze the differences and correlations.
Results: There were no differences in sex, age, the affected side, and positional nystagmus between the light cupula group and HC-cu group ( > 0.05). The overall abnormal rate of the vHIT (56.86% vs. 21.43%), the abnormal rate of the affected side (23.53% vs. 0.00%), and the saccade ratio of the affected side [40.0 (13.0, 76.0) vs. 6.0 (0.0, 15.0)] in the light cupula group were higher than those in the HC-cu group. The HC saccade ratio in the light cupula group was higher on the affected side than on the healthy side [40.0 (13.0, 76.0) vs. 11.0 (0.0, 38.0)], and the differences were statistically significant ( < 0.05). The receiver operating characteristic (ROC) curve analysis showed that the abnormal vHIT results and saccade ratio of the light cupula group were correlated with the affected side ( < 0.05).
Conclusion: The vHIT results of idiopathic HC light cupula and HC-Cu were different as they are distinct diseases. Light cupula may be associated with some mild lesions in the vestibulo-ocular reflex (VOR) pathway. The lighter cupula theory is the possible mechanism.
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http://dx.doi.org/10.3389/fneur.2024.1496430 | DOI Listing |
Front Neurol
August 2025
Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
Objectives: Persistent direction-changing positional nystagmus (DCPN) and null point (NP) are characteristic of cupulopathy of the horizontal semicircular canal (HSC). The cupulopathy can manifest as HSC-light cupula (HSC-Lcu) (geotropic DCPN) and HSC-heavy cupula (HSC-Hcu) (apogeotropic DCPN) in the supine roll test (SRT). Whether the affected side of cupulopathy could be based on the nystagmus intensity in the SRT is controversial.
View Article and Find Full Text PDFJ Vestib Res
May 2025
Department of Neurology, Dizziness Center, Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Background and PurposePrevious studies on benign paroxysmal positional vertigo (BPPV) have primarily been performed in referral-based clinics. This study aimed to explore the clinical characteristics of BPPV and its variant (light cupula) in a primary care setting.MethodsWe retrospectively analyzed the clinical data of 1126 patients who visited a primary care neurology clinic due to dizziness or vertigo between March 2023 and February 2024.
View Article and Find Full Text PDFAudiol Res
May 2025
Department of Neuroradiology, AUSL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy.
Vestibular atelectasis (VA) is a rare clinical entity characterized by a collapse of the endolymphatic space resulting in vestibular loss with the possible onset of positional and/or sound/pressure-induced vertigo. It could be idiopathic or secondary to other inner-ear diseases including Meniere's disease (MD). A collapse of the membranous labyrinth involving the semicircular canals (SCs) and the utricle represents its distinctive histopathological feature.
View Article and Find Full Text PDFClin Exp Otorhinolaryngol
April 2025
Department of Otorhinolaryngology, Yonsei University College of Medicine.
Objective: To investigate the pathophysiology of persistent geotropic direction-changing positional nystagmus (pGeo DCPN) by analyzing the caloric responses and clinical course in patients with pGeo DCPN and other variants of lateral semicircular canal benign paroxysmal positional vertigo (LSCC BPPV).
Methods: In this case-control prospective study, 101 patients diagnosed with pGeo DCPN (pGeo group, N=34), persistent apogeotropic (pApo) DCPN (pApo group, N=40), or transient geotropic (tGeo) DCPN (tGeo group, N=27) involving the LSCC were enrolled. The video head impulse test (vHIT) and caloric test were performed on the day of diagnosis.
J Neurol
February 2025
Laboratory of Vestibular NeuroAdaptation, Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline St, Rm 6245, Baltimore, MD, 21287, USA.
Background: The underlying etiologies responsible for persistent geotropic nystagmus (PGN) and apogeotropic nystagmus (PAGN) remain elusive. In this study, we analyzed the symptoms of patients with PGN and PAGN and categorize them based on diagnostic criteria for established vestibular disorders.
Methods: Clinical signs, recurrences, and duration of vestibular symptoms in patients with PGN or PAGN were collated and included auditory, neurologic, and migrainous symptoms as well as migraine history.