Document Detail

Head position during resting modifies spontaneous daytime decrease of downbeat nystagmus.
MedLine Citation:
PMID:  21098408     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The intensity of downbeat nystagmus (DBN) decreases during the daytime when the head is in upright position.
OBJECTIVE: This prospective study investigated whether resting in different head positions (upright, supine, prone) modulates the intensity of DBN after resting.
METHODS: Eye movements of 9 patients with DBN due to cerebellar (n = 2) or unknown etiology (n = 7) were recorded with video-oculography. Mean slow-phase velocities (SPV) of DBN were determined in the upright position before resting at 9 am and then after 2 hours (11 am) and after 4 hours (1 pm) of resting. Whole-body positions during resting were upright, supine, or prone. The effects of all 3 resting positions were assessed on 3 separate days in each patient.
RESULTS: Before resting (9 am), the average SPV ranged from 3.05 °/s to 3.6 °/s on the separate days of measurement. After resting in an upright position, the average SPV at 11 am and 1 pm was 0.65 °/sec, which was less (p < 0.05) than after resting in supine (2.1 °/sec) or prone (2.22 °/sec) positions.
CONCLUSION: DBN measured during the daytime in an upright position becomes minimal after the patient has rested upright. The spontaneous decrease of DBN is less pronounced when patients lie down to rest. This indicates a modulation by otolithic input. We recommend that patients with DBN rest in an upright position during the daytime.
CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that for patients with DBN 2 hours of rest in the upright position decreases nystagmus more than 2 hours of rest in the supine or prone positions (relative improvement 79% upright, 33% supine, and 38% prone: p < 0.05).
R Spiegel; R Kalla; N Rettinger; E Schneider; D Straumann; S Marti; S Glasauer; T Brandt; M Strupp
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Publication Detail:
Type:  In Vitro; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurology     Volume:  75     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-04     Revised Date:  2011-08-25    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1928-32     Citation Subset:  AIM; IM    
Department of Neurology and IFB, Ludwig-Maximilians-University, Campus Grosshadern, Marchioninistr. 15, 81377 Munich, Germany.
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MeSH Terms
Circadian Rhythm*
Eye Movements
Middle Aged
Nystagmus, Pathologic / physiopathology*
Prone Position
Prospective Studies
Supine Position
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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