Effect of ocular fixation on positional nystagmus in BPPV patients

Abstract

Objective

The quantitative suppression rate of positional nystagmus (PN) by ocular fixation (OF) is unknown. This study aims to analyse the effect of OF on the slow phase velocity (SPV) of PN during diagnostic positional manoeuvres (DPMs) with videonystagmography in patients with benign paroxysmal positional vertigo (BPPV).

Design

DPMs were performed on 58 patients with BPPV, 33 (56.9%) of whom were women. OF was initiated when PN was most evident, and recording was continued. The mean SPV of three consecutive nystagmus before (F0) and after (F1) OF initiation was calculated. The rate of suppression of PN by OF was found in percent with the formula (F0 – F1) x 100/F0.

Study Sample

58 patients were included in this study.

Results

The mean age was 56.1 ± 11.2 (range 27–76). F0 and F1 values were calculated as 5.742 ± 5.589 and 1.948 ± 3.424 degrees/second, respectively (p < 0.001). The rate of suppression of PN by OF was found to be 66.1%.

Conclusions

OF significantly suppresses PN during DPMs in BPPV patients. Elimination of OF during DPMs is important for accurate diagnosis.

Keywords:

• Benign paroxysmal positional vertigo
• ocular fixation
• positional nystagmus
• videonystagmography

Acknowledgments

This study was conducted in a tertiary reference hospital with the approval of the ethics committee of the University of Health Sciences Kocaeli Derince Training and Research Hospital. The ethical approval number is 2021-109.

This study was presented as an oral presentation at the 42^nd Turkish National Congress of Otorhinolaryngology and Head and Neck Surgery held in Antalya on 3-7 November 2021.

Disclosure statement

The authors declare that they have no conflicts of interest.