{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T05:10:00Z","timestamp":1738905000294,"version":"3.37.0"},"reference-count":0,"publisher":"American Academy of Audiology","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["j am acad audiol"],"published-print":{"date-parts":[[2008,3,1]]},"abstract":"<jats:p>Down-beating positional nystagmus is typically associated with central nervous system disease. Anterior canal benign paroxysmal positional vertigo (AC-BPPV) can mimic down-beating positional nystagmus of central origin, particularly when it is bilateral. Factors that increase the probability\n of bilateral AC-BPPV include a history of bilateral multicanal BPPV, transient down-beating and torsional nystagmus that follows the plane of the provoked canal, and the absence of co-occurring neurologic signs and symptoms of central nervous system dysfunction. With neurologic clearance for\n canalith repositioning, exploration for AC-BPPV and canalith repositioning trials may alleviate symptoms even when the nystagmus does not appear to fatigue. In the case presented, the use of a side-lying maneuver with the nose down to provoke AC-BPPV symptoms and the use of a reversed Epley\n to clear AC-BPPV symptoms are highlighted. This approach is helpful when the diagnosis is unclear and neck hyperextension is to be avoided. El nistagmo posicional de batida hacia abajo est\u00e1 t\u00edpicamente asociado con enfermedades del sistema nervioso central. El v\u00e9rtigo\n posicional parox\u00edstico benigno del canal anterior (AC-BPPV) puede simular un nistagmo posicional de batida hacia abajo de origen central, particularmente cuando es bilateral. Los factores que influyen sobre la probabilidad de un AC-BPPV bilateral incluyen una historia de BPPV multicanal\n bilateral, de nistagmo transitorio de batida hacia abajo o de nistagmo de torsi\u00f3n, que sigue el plano del canal provocado, y la ausencia de signos y s\u00edntomas neurol\u00f3gicos concurrentes por una disfunci\u00f3n del sistema nervioso central. Con una depuraci\u00f3n neurol\u00f3gica\n de reposici\u00f3n canalicular, la exploraci\u00f3n buscando AC-BPPV y los intentos de reposicionamiento canalicular pueden aliviar los s\u00edntomas a\u00fan cuando el nistagmo no parezca fatigarse. En el caso presentado, se destaca el uso de la maniobra de dec\u00fabito lateral\n con descenso de la nariz para provocar los s\u00edntomas del AC-BPPV. Este enfoque es \u00fatil cuando el diagn\u00f3stico no es claro y se debe evitar la hiperextensi\u00f3n del cuello.<\/jats:p>","DOI":"10.3766\/jaaa.19.3.10","type":"journal-article","created":{"date-parts":[[2008,7,19]],"date-time":"2008-07-19T21:26:34Z","timestamp":1216502794000},"page":"257-266","source":"Crossref","is-referenced-by-count":13,"title":["Down-Beating Nystagmus in Anterior Canal Benign Paroxysmal Positional Vertigo"],"prefix":"10.3766","volume":"19","author":[{"given":"David A.","family":"Zapala","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2087","container-title":["Journal of the American Academy of Audiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/aaa\/jaaa\/2008\/00000019\/00000003\/art00010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T07:55:13Z","timestamp":1738828513000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.3766\/jaaa.19.3.10"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,3,1]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2008,3,1]]}},"alternative-id":["1050-0545(20080301)19:3L.257;1-"],"URL":"https:\/\/doi.org\/10.3766\/jaaa.19.3.10","relation":{},"ISSN":["1050-0545"],"issn-type":[{"type":"print","value":"1050-0545"}],"subject":[],"published":{"date-parts":[[2008,3,1]]}}}