{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T02:42:47Z","timestamp":1794278567211,"version":"4.9.0"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the topical diagnosis and etiologies of spontaneous nystagmus (SN) with an upbeat component.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively recruited 43 patients with SN with an upbeat component at a university hospital in China from 2020 to 2022. SN with an upbeat component was divided into pure upbeat nystagmus (UBN), SN with a predominant upbeat component, and SN with a non-predominant upbeat component. We analyzed their clinical and neurotologic findings and the final diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen (32.6%) of them showed pure UBN, while 29 (67.4%) exhibited SN mixed with an upbeat component, mixed upbeat-horizontal in 15, mixed upbeat-horizontal-torsional in 13, and upbeat-torsional in the remaining one. Pure UBN and SN with a predominant upbeat component were more common in central than in peripheral vestibular disorders [16 (80.0%) vs. 0 (0%), Chi-Square test, <jats:italic>p<\/jats:italic> &amp;lt; 0.001]. Central vestibular disorders were diagnosed in 20 (46.5%) patients, peripheral in 14 (32.6%), and undetermined in nine (20.9%) patients. The underlying causes mainly included acute unilateral peripheral vestibulopathy (<jats:italic>n<\/jats:italic> = 11), posterior circulation infarction (<jats:italic>n<\/jats:italic> = 9), benign recurrent vertigo (<jats:italic>n<\/jats:italic> = 4), vestibular migraine (VM, <jats:italic>n<\/jats:italic> = 3), and VM of childhood (<jats:italic>n<\/jats:italic> = 2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SN with an upbeat component can be seen in both central and peripheral vestibular disorders. Pure UBN was a characteristic sign of central vestibular dysfunction. Central vestibular disorders should be highly suspected when patients show pure UBN or SN with a predominant upbeat component.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1106084","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T05:36:09Z","timestamp":1677130569000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Spontaneous nystagmus with an upbeat component: Central or peripheral vestibular disorders?"],"prefix":"10.3389","volume":"14","author":[{"given":"Xia","family":"Ling","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue-Xia","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Fei","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong-Tong","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gui-Ping","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Soo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhao-Xia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3233\/VES-190658","article-title":"Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements","volume":"29","author":"Eggers","year":"2019","journal-title":"J Vestibul Res."},{"key":"B2","doi-asserted-by":"publisher","first-page":"58","DOI":"10.3988\/jcn.2006.2.1.58","article-title":"Upbeat nystagmus: Clinicoanatomical correlations in 15 patients","volume":"2","author":"Kim","year":"2006","journal-title":"J Clin Neurol."},{"key":"B3","doi-asserted-by":"crossref","DOI":"10.1093\/med\/9780199969289.001.0001","volume-title":"The Neurology of Eye Movements.","author":"Leigh","year":"2015"},{"key":"B4","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1097\/00129492-200209000-00021","article-title":"The Chiari I malformation and the neurotologist","volume":"23","author":"Kumar","year":"2002","journal-title":"Otol Neurotol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1038\/sj.eye.6700529","article-title":"Primary position upbeat nystagmus associated with amitriptyline use","volume":"18","author":"Osborne","year":"2004","journal-title":"Eye."},{"key":"B6","first-page":"318","volume-title":"Primary Position Upbeat Nystagmus With Organophosphate Poisoning","author":"Jay","year":"1982"},{"key":"B7","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1002\/ana.410210110","article-title":"Tabacco-induced primary-position upbeat nystagmus","volume":"21","author":"Sibony","year":"1987","journal-title":"Ann Neurol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e2743","DOI":"10.1212\/WNL.0000000000007644","article-title":"Capturing acute vertigo: A vestibular event monitor","volume":"92","author":"Young","year":"2019","journal-title":"Neurology."},{"key":"B9","doi-asserted-by":"publisher","first-page":"153","DOI":"10.7874\/jao.2021.00297","article-title":"Spontaneous upbeat nystagmus and selective anterior semicircular canal hypofunction on video head impulse test: A new variant of canalith jam?","volume":"26","author":"Castellucci","year":"2022","journal-title":"J Audiol Otol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"460757","DOI":"10.1155\/2015\/460757","article-title":"A puzzle of vestibular physiology in a Meniere's disease acute attack","volume":"2015","author":"Martinez-Lopez","year":"2015","journal-title":"Case Rep Otolaryngol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/j.anorl.2018.08.001","article-title":"Delayed endolymphatic hydrops. 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