{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:46:09Z","timestamp":1791927969994,"version":"4.3.4"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To describe transient post\u2013head-shaking nystagmus associated with horizontal canal benign paroxysmal positional vertigo (BPPV) and its resolution following canalith repositioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 78-year-old woman presented with positional vertigo. Video-oculography revealed left-beating pseudo-spontaneous nystagmus and a robust left-beating pHSN, initially suggestive of uncompensated unilateral vestibulopathy. Further bedside assessment, including the Head Pitch test and Supine Roll test, demonstrated direction-changing horizontal nystagmus consistent with left horizontal canalolithiasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After an unsuccessful Lempert maneuver, a Gufoni maneuver was performed, resulting in immediate resolution of vertigo and nystagmus. At 10-day follow-up, no spontaneous, positional, or post-head-shaking nystagmus was observed. The patient remained asymptomatic throughout 14-month follow-up, with preserved horizontal vHIT responses at reassessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case suggests that post\u2013head-shaking nystagmus in horizontal canal BPPV may arise from transient mechanically triggered asymmetry rather than a fixed vestibular deficit. Reliance on pHSN alone may lead to misdiagnosis and inappropriate diagnostic interpretation. Incorporating positional testing and reassessment following canalith repositioning may help avoid misinterpretation of post\u2013head-shaking nystagmus as unilateral vestibular hypofunction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-026-10640-y","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:00:30Z","timestamp":1791925230000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reversible post\u2013head-shaking nystagmus in horizontal canal BPPV as a mechanical mimic of vestibular hypofunction: a case report"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7656-3537","authenticated-orcid":false,"given":"Hadas","family":"Ben-Rubi Shimron","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Castellucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoav","family":"Gimmon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"issue":"7","key":"10640_CR1","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1177\/000348949009900708","volume":"99","author":"GP Jacobson","year":"1990","unstructured":"Jacobson GP, Newman CW, Safadi I (1990) Sensitivity and specificity of the head-shaking test for detecting vestibular system abnormalities. Ann Otol Rhinol Laryngol 99(7):539\u2013542","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"1","key":"10640_CR2","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/S0196-0709(87)80017-0","volume":"8","author":"TC Hain","year":"1987","unstructured":"Hain TC, Fetter M, Zee DS (1987) Head-shaking nystagmus in patients with unilateral peripheral vestibular lesions. Am J Otolaryngol 8(1):36\u201347","journal-title":"Am J Otolaryngol"},{"issue":"7","key":"10640_CR3","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1111\/ene.14161","volume":"27","author":"T-H Yang","year":"2020","unstructured":"Yang T-H, Lee J-H, Oh S-Y, Kang J-J, Kim J-S, Dieterich M (2020) Clinical implications of head\u2010shaking nystagmus in central and peripheral vestibular disorders: is perverted head\u2010shaking nystagmus specific for central vestibular pathology? Eur J Neurol 27(7):1296\u20131303","journal-title":"Eur J Neurol"},{"issue":"2","key":"10640_CR4","doi-asserted-by":"publisher","first-page":"95","DOI":"10.3233\/VES-200696","volume":"30","author":"H Lee","year":"2020","unstructured":"Lee H, Kim HA (2020) The association of head shaking nystagmus with head-bending and lying-down nystagmus in horizontal canal benign paroxysmal positional vertigo. J Vestib Res 30(2):95\u2013100","journal-title":"J Vestib Res"},{"issue":"4","key":"10640_CR5","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1097\/MAO.0b013e31824950c7","volume":"33","author":"M-B Kim","year":"2012","unstructured":"Kim M-B, Huh SH, Ban JH (2012) Diversity of head shaking nystagmus in peripheral vestibular disease. Otol Neurotol 33(4):634\u2013639","journal-title":"Otol Neurotol"},{"issue":"12","key":"10640_CR6","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1080\/00016480701275253","volume":"127","author":"JA Lopez-Escamez","year":"2007","unstructured":"Lopez-Escamez JA, Zapata C, Molina MI, Palma MJ (2007) Dynamics of canal response to head-shaking test in benign paroxysmal positional vertigo. Acta Otolaryngol 127(12):1246\u20131254","journal-title":"Acta Otolaryngol"},{"issue":"5","key":"10640_CR7","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10050916","volume":"10","author":"H Lee","year":"2021","unstructured":"Lee H, Kim HA (2021) Head-shaking nystagmus in posterior canal benign paroxysmal positional vertigo with canalolithiasis. J Clin Med 10(5)","journal-title":"J Clin Med"},{"issue":"2","key":"10640_CR8","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/j.amjoto.2018.12.005","volume":"40","author":"A Castellucci","year":"2019","unstructured":"Castellucci A, Malara P, Brandolini C et al (2019) Isolated horizontal canal hypofunction differentiating a canalith jam from an acute peripheral vestibular loss. Am J Otolaryngol 40(2):319\u2013322","journal-title":"Am J Otolaryngol"},{"issue":"5","key":"10640_CR9","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1007\/s00405-013-2494-0","volume":"271","author":"BB Babic","year":"2014","unstructured":"Babic BB, Jesic SD, Milovanovic JD, Arsovic NA (2014) Unintentional conversion of benign paroxysmal positional vertigo caused by repositioning procedures for canalithiasis: transitional BPPV. Eur Arch Otorhinolaryngol 271(5):967\u2013973. https:\/\/doi.org\/10.1007\/s00405-013-2494-0","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"8","key":"10640_CR10","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1016\/j.jbiomech.2003.12.014","volume":"37","author":"TM Squires","year":"2004","unstructured":"Squires TM, Weidman MS, Hain TC, Stone HA (2004) A mathematical model for the canalithiasis theory of benign paroxysmal positional vertigo. J Biomech 37(8):1137\u20131146","journal-title":"J Biomech"},{"key":"10640_CR11","doi-asserted-by":"publisher","first-page":"1533842","DOI":"10.3389\/fneur.2025.1533842","volume":"16","author":"IS Curthoys","year":"2025","unstructured":"Curthoys IS, Zee DS, Dumas G, Pastras CJ, Dlugaiczyk J (2025) Skull vibration induced nystagmus, velocity storage and self-stability. Front Neurol 16:1533842. https:\/\/doi.org\/10.3389\/fneur.2025.1533842","journal-title":"Front Neurol"}],"container-title":["European Archives of Oto-Rhino-Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-026-10640-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00405-026-10640-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-026-10640-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:00:31Z","timestamp":1791925231000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00405-026-10640-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":11,"alternative-id":["10640"],"URL":"https:\/\/doi.org\/10.1007\/s00405-026-10640-y","relation":{},"ISSN":["0937-4477","1434-4726"],"issn-type":[{"value":"0937-4477","type":"print"},{"value":"1434-4726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]},"assertion":[{"value":"1 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This case report received ethics approval from the Sheba Medical Center Ethics Committee (approval number: [9581\u201322-SMC]).","order":1,"name":"Ethics","label":"<b>Ethical Considerations<\/b>","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The patient provided written informed consent for publication of the clinical information and accompanying video material.","order":2,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no financial or non-financial competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}