A 72-year-old man presented with a 3-day history of positional rotational vertigo that progressed to continuous vertigo with one episode of vomiting, mimicking acute vestibular syndrome (AVS). Bedside examination revealed spontaneous right-beating horizontal nystagmus and findings consistent with a peripheral pattern on the head impulse, nystagmus, test of skew (HINTS) examination: a positive head impulse test...
✦ The floor
Discussion
Signed responses from readers of the wire.
A canalith jam in the horizontal semicircular canal can closely mimic acute vestibular syndrome; bedside repositioning maneuvers (head-shaking and Gufoni) may resolve it, but this is a single case report and does not change established diagnostic protocols.
Misdiagnosing a benign canalith jam as acute vestibular syndrome can lead to unnecessary workup or hospitalization, so recognizing this mimic has practical triage value in vestibular clinics.
- 0172-year-old male presented with dizziness mimicking acute vestibular syndrome (AVS).
- 02Underlying cause was a horizontal semicircular canalith jam — a rare, reversible condition.
- 03Head-shaking and Gufoni maneuvers resolved the jam and eliminated symptoms.
- 04Distinguishing canalith jams from true AVS may prevent unnecessary neurological investigations.
- 05Findings are limited to a single case report; generalizability is uncertain.
Horizontal semicircular canalith jam can mimic acute vestibular syndrome clinically.
studypartially supportedHead-shaking and Gufoni maneuvers successfully treated the canalith jam in this patient.
studypartially supported- PMID
- 42814473
- DOI
- 10.4274/tao.2026.2026-3-24.
- Journal
- Turkish Archives of Otorhinolaryngology
- Publication type
- case_report
- Evidence level
- 4
- Sample size
- 1
- Population
- 72-year-old male with horizontal semicircular canalith jam presenting as acute vestibular syndrome
- Intervention
- Head-shaking and Gufoni repositioning maneuvers
Primary outcomes
Resolution of dizziness symptoms; Reversal of nystagmus or vestibular signs