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Central Positional Nystagmus: A Systematic Literature Review
Nora K Macdonald1, Diego Kaski2, Yougan Saman1
1Neuro-otology Department, National Hospital for Neurology and Neurosurgery, London, UK.
Frontiers in Neurology
|May 6, 2017
Summary
Central positional nystagmus (CPN) often presents with atypical nystagmus direction and can involve the cerebellum. More research is needed to differentiate CPN from peripheral causes and identify underlying conditions.
Area of Science:
- Neurology
- Ophthalmology
- Otolaryngology
Background:
- Central positional nystagmus (CPN) can mimic peripheral causes of positional nystagmus (PN), complicating diagnosis.
- Distinguishing CPN from peripheral PN is crucial for identifying potentially serious underlying neurological conditions.
Purpose of the Study:
- To systematically review the clinical and radiological features of lesion-induced CPN.
- To identify characteristics that differentiate CPN from peripheral PN.
Main Methods:
- Systematic literature search adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Analysis of clinical and radiological data from 82 patients across 28 studies.
Main Results:
- Atypical nystagmus direction was observed in 97.5% of patients during Dix-Hallpike testing.
- Common CPN types included positional horizontal nystagmus (36.8%) and positional downbeating nystagmus (29.2%).
- Cerebellar involvement was noted in 74.4% of radiological findings, with concurrent vertigo reported in 63.4% of patients.
Conclusions:
- Limited robust data exists for CPN, necessitating improved phenotyping for differentiation from peripheral PN.
- Increased awareness and better clinical markers are required for prompt identification of sinister underlying causes of CPN.
