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Case Reports in Otolaryngology
Volume 2016, Article ID 1249325, 3 pages
Case Report

Persistent Down-Beating Torsional Positional Nystagmus: Posterior Semicircular Canal Light Cupula?

1Department of Otorhinolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
2Ichimura ENT Clinic, 2-11-10 Nishiwaseda, Shinjuku-ku, Tokyo 169-0051, Japan

Received 9 July 2016; Revised 14 August 2016; Accepted 17 August 2016

Academic Editor: Nicolas Perez-Fernandez

Copyright © 2016 Akihide Ichimura and Koji Otsuka. 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.


A 16-year-old boy with rotatory positional vertigo and nausea, particularly when lying down, visited our clinic. Initially, we observed vertical/torsional (downward/leftward) nystagmus in the supine position, and it did not diminish. In the sitting position, nystagmus was not provoked. Neurological examinations were normal. We speculated that persistent torsional down-beating nystagmus was caused by the light cupula of the posterior semicircular canal. This case provides novel insights into the light cupula pathophysiology.