[Preliminary analysis of central paroxysmal positional vertigo]

Area of Science:

• Neurology
• Otorhinolaryngology
• Vestibular System

Background:

• Central paroxysmal positional vertigo (CPPV) is a condition characterized by vertigo triggered by head position changes.
• Its exact pathogenesis remains incompletely understood, necessitating further investigation into central vestibular pathways.

Purpose of the Study:

• To investigate the underlying pathogenesis of CPPV by analyzing clinical features and diagnostic findings.
• To identify potential central nervous system mechanisms contributing to CPPV.

Main Methods:

• Retrospective analysis of clinical data from 3 CPPV patients (1 male, 2 females; ages 36, 14, 70).
• Evaluation included clinical symptoms, nystagmus, oculomotor abnormalities, MRI, PET-CT, and laboratory tests.
• Analysis focused on identifying lesions within the central velocity storage mechanism.

Main Results:

• All patients experienced transient vertigo and nystagmus with head movements, but atypical nystagmus characteristics were observed.
• Repositioning maneuvers were ineffective; patients exhibited abnormal visual oculomotor signs or other central nervous system symptoms.
• Causes identified included chronic hemorrhage, inflammation, and paraneoplastic cerebellar degeneration, all affecting the central velocity storage mechanism.

Conclusions:

• Damage to the central velocity storage mechanism appears to be a key factor in CPPV pathogenesis.
• This damage likely disrupts the feedback rotation signal correction pathway, resulting in CPPV symptoms during head position changes.