{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:10:47Z","timestamp":1786122647565,"version":"build-2736575974"},"reference-count":36,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T00:00:00Z","timestamp":1766793600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Vestibular Research"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Positional downbeat nystagmus (pDBN) may have multiple etiologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Description of a case series and further considerations about pDBN characteristics, pathogenesis, and differential diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Descriptive study concerning 153 consecutive patients with pDBN of presumed peripheral origin that were recruited and observed. They were treated only with Brandt-Daroff Exercises.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>56% reported symptoms of \u201ctypical positional vertigo,\u201d 44% described postural instability during head movements or a continuous sense of dizziness. 40% of patients were symptom- and nystagmus-free after 1\u00a0week and almost 60% after 2\u00a0weeks 5% were still affected by pDBN after 1\u00a0month. Several pathogenetic hypotheses have been advanced: otoconia in the anterior canal, an apogeotropic variant of posterior canal, or in the short arm of the posterior canal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Down-beat nystagmus arising from the semicircular canals must contain a torsional component and be in \u201ccanal-plane\u201d - presenting more torsional when gaze is towards the affected canal, and more purely vertical when directed away, whereas central causes of DBN may be \u201cpure\u201d down-beat. Peripheral pDBN is fatigable, often no nystagmus when returning in sitting position and, highly relevantly, it is self-limiting (95% disappears with only Brandt-Daroff Exercises), with no central signs. Patients may complain of long-term dizziness, trunk oscillation, and prolonged motion sickness. New guidelines may consider the term of Down-Beating BPPV or Down-Beating peripheral positional vertigo, even if the otoconia\u2019s exact position is still uncertain: in our opinion pDBN might be considered as an \u201capogeotropic variant of PC-BPPV\u201d.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09574271251412829","type":"journal-article","created":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T13:36:38Z","timestamp":1766842598000},"page":"289-297","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Bedside evaluation of peripheral positional downbeating nystagmus: Toward the new definition of down-beating BPPV"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2720-2118","authenticated-orcid":false,"given":"Francesca","family":"Viberti","sequence":"first","affiliation":[{"name":"University of Siena"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Nuti","sequence":"additional","affiliation":[{"name":"University of Siena"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Salerni","sequence":"additional","affiliation":[{"name":"University of Siena"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Mandal\u00e0","sequence":"additional","affiliation":[{"name":"University of Siena"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,27]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-012-6815-9"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2007.35"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.72.3.366"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/NPT.0000000000000276"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000245"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2019.15.2.143"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.4081\/audiores.2015.130"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2022.09.008"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200211000-00019"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-3402733"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3109\/00016489509125213"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/413603"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/16513860510028310"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000197"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.14639\/0392-100X-N1032"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002500"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.578588"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-63437-5.00005-4"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.4103\/aian.aian_357_24"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjorl.2022.12.001"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjorl.2020.09.009"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.3109\/14992021003753490"},{"key":"e_1_3_3_24_2","first-page":"465","article-title":"Paroxysmal positional vertigo syndrome","volume":"20","author":"Honrubia V","year":"1999","unstructured":"Honrubia V, Baloh RW, Harris MR, et al. 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