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Case Reports in Otolaryngology
Volume 2015, Article ID 192764, 3 pages
Case Report

Intractable Persistent Direction-Changing Geotropic Nystagmus Improved by Lateral Semicircular Canal Plugging

Department of Otolaryngology, Kinki University Faculty of Medicine, 377-2 Ohno-higashi, Osakasayama, Osaka 589-8511, Japan

Received 9 September 2014; Revised 1 December 2014; Accepted 15 December 2014

Academic Editor: Dimitrios G. Balatsouras

Copyright © 2015 Toru Seo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Antigravitational deviation of the cupula of the lateral semicircular canal, which is also called light cupula, evokes persistent direction-changing geotropic nystagmus with a neutral point. No intractable cases of this condition have been reported. In our case, a 67-year-old man complained of positional vertigo 3 months after developing idiopathic sudden hearing loss in the right ear with vertigo. He showed a persistent direction-changing geotropic nystagmus with a leftward beating nystagmus in the supine position. The nystagmus resolved when his head was turned approximately 30° to the right. He was diagnosed with light cupula of the right lateral semicircular canal and was subsequently treated with an antivertiginous agent. However, his symptoms and positional nystagmus did not improve, so the right lateral semicircular canal was plugged by surgery. One month after surgery, his positional vertigo and nystagmus were completely resolved. We speculated that the cause of the patient’s intractable light cupula was an enlarged cupula caused by his idiopathic sudden hearing loss.