수평반고리관 양성 돌발성 두위 현훈에서누울 때 나타나는 안진의 의의 = Significance of Lying-Down Nystagmus in the Lateralization of Lateral Canal Benign Paroxysmal Positional Vertigo

다국어 초록 (Multilingual Abstract)

Background and Objectives：Lateral canal benign paroxysmal positional vertigo (LC-BPPV) is characterized by horizontal
direction changing nystagmus induced by lateral head turning in supine position. According to the Ewald’s second law, the direction
of head turning that creates stronger response represents the affected side of geotropic nystagmus and the healthy side in apogeotropic
nystagmus. However, it may not always be possible to lateralize the involved ear only by comparing the intensity of the
nystagmus. We studied the values of lying-down nystagmus (LDN) in the lateralization of LC-BPPV. Subjects and Method：
We performed a retrospective study of 54 patients who had been diagnosed as having LC-BPPV in Dizziness Clinic of Seoul National
University Bundang Hospital from May 2003 to February 2004. The directions of the nystagmus induced by lying down
were compared with those determined by the Ewald’s second law. Results：Of the 54 patients, 32 (20 apogeotropic and 12 geotropic)
patients showed horizontal nystagmus induced by lying down. The nystagmus was ipsilesional in 16 (80%) apogeotropic
and contralesional in 9 (75%) geotropic patients. Conclusion：In LC-BPPV, the LDN mostly beats toward the involved ear in
the apogeotropic type, and directs to the healthy ear in the geotropic type. The direction of LDN may help lateralizing the involved
ear in LC-BPPV.

참고문헌 (Reference)

1 "The treatment of horizontalcanal positional vertigo:Our experience in 66 cases" 112 : 172-178, 2002

2 "The pathology, symptomatology, and diagnosisof certain common disorders of the vestibular system." 54 : 341-354, 1952

3 "Positional nystagmus in the dark in normal subjects" 24 : 283-290, 2000

4 "Persistent directionchanging positional nystagmus: Another variant of benign positionalnystagmus?" 45 : 1297-1301, 1995

5 "Horizontal semicircular canalvariant of benign positional vertigo" 43 : 2542-2549, 1993

6 "Horizontal canal BPV" 14 : 30-35, 1985

7 "Effectivenessof cupulolith repositioning maneuver in the treatment of lateral semicircularcanal cupulolithiasis" 43 : 1147-1157, 2000

8 "Directional changingpositional nystagmus from canalolithiasis and cupulolithiasis oflateral semicircular canal" 42 : 76-81, 1999

9 "Diagnose von krankheitsercheimtngen im bereiche desotolighenapparates" 2 : 434-437, 1920

10 "Benign paroxysmal vertigo of thehorizontal canal" 51 : 161-170, 1989

11 "Benign paroxysmal positional vertigo" 47 : 491-506, 2004

12 "Benigh positional vertigo:Clinicaland oculographic features in 240 cases" 37 : 371-378, 1987

13 "A new differential diagnosis for spontaneousnystagmus:Lateral canal cupulolithiasis" 956 : 579-580, 2002