To describe transient post-head-shaking nystagmus associated with horizontal canal benign paroxysmal positional vertigo (BPPV) and its resolution following canalith repositioning.
✦ The floor
Discussion
Signed responses from readers of the wire.
Clinicians should rule out BPPV via Dix-Hallpike/roll test before diagnosing vestibular hypofunction from post-head-shaking nystagmus alone, as horizontal canal BPPV can mechanically mimic hypofunction and resolves with canalith repositioning.
Misattributing BPPV-related nystagmus to vestibular hypofunction could lead to unnecessary investigation and delayed treatment of a highly manageable condition.
- 01A single case of horizontal canal BPPV produced post-head-shaking nystagmus that resembled vestibular hypofunction.
- 02The false-positive vestibular test result fully reversed after canalith repositioning maneuver.
- 03BPPV (dislodged inner-ear crystals) can mechanically mimic unilateral vestibular loss on standard tests.
- 04Differential diagnosis of BPPV is critical before interpreting post-head-shaking nystagmus as pathological.
- 05Case highlights a diagnostic pitfall relevant to balance clinics and neuro-otology practices.
Horizontal canal BPPV can produce post-head-shaking nystagmus that mimics vestibular hypofunction, reversible after canalith repositioning.
studypartially supported- PMID
- 42867662
- DOI
- 10.1007/s00405-026-10640-y.
- Journal
- European Archives of Oto-Rhino-Laryngology
- Publication type
- case_report
- Evidence level
- 4
- Sample size
- 1
- Population
- Single patient with horizontal canal BPPV
- Intervention
- Canalith repositioning maneuver
Primary outcomes
Resolution of post-head-shaking nystagmus; Reversal of apparent vestibular hypofunction