Vestibular deficit and recovery in rare forms of benign paroxysmal positional vertigo with downbeat nystagmus

The primary goals are to investigate the rate of vestibular deficit (VD) during the acute attack and to follow up on vestibular recovery (VR) after the resolution of BPPV in patients with rare forms of BPPV that cause downbeat nystagmus. Second, to determine the effects of VD on dizziness severity in patients with rare BPPV forms and to compare all the results with those of typical posterior canal BPPV.

Clinicians managing BPPV should be aware that rare downbeat-nystagmus variants may involve measurable vestibular deficits that partially recover after canal repositioning; standard repositioning manoeuvres remain appropriate, but vestibular function testing may be warranted post-treatment in these atypical presentations.

Downbeat-nystagmus BPPV is poorly characterised; quantifying vestibular deficit and recovery patterns in this subtype could refine diagnostic criteria and help explain why some patients have residual symptoms after apparently successful repositioning.

1. 01Study focused on rare BPPV variants that present with downbeat nystagmus (an unusual downward eye movement).
2. 02Vestibular (balance system) deficit levels were measured during acute attacks.
3. 03Recovery of vestibular function was assessed after BPPV episodes resolved.
4. 04Findings may explain persistent symptoms in some patients despite successful canal repositioning.
5. 05Expands understanding of BPPV pathophysiology beyond the classic posterior-canal type.

PMID

42165886

DOI

10.1007/s00405-026-10289-7.

Journal

European Archives of Oto-Rhino-Laryngology

Publication type

research_article

Evidence level

4

Population

Patients with rare BPPV variants presenting with downbeat nystagmus

Intervention

Vestibular function assessment during and after BPPV episodes with downbeat nystagmus