Valsalva and Hyperventilation induced Nystagmus

Research in Vestibular Science > Volume 9(0); 2010 > Article

Research in Vestibular Science 2010;9(0): 41-44.

발살바, 과호흡 유발안진

최광동

부산대학교 의과대학 신경과학 교실

Valsalva and Hyperventilation induced Nystagmus

Kwang-Dong Choi, MD

Department of Neurology, Pusan National University Hospital, Pusan, Korea

ABSTRACT

Hyperventilation may elicit nystagmus by bring out vestibular asymmetry in central as well as peripheral vestibulopathies, including compensated peripheral vestibulopathies, perilymph fistula, acoustic neuroma, lesions at craniocervical junction, and cerebellar degeneration. A recent study documented that hyperventilation-induced nystagmus (HIN) beating to the side of reduced caloric response, hearing impairment, or abnormal auditory brainstem response may be a valuable sign for bedside detection of acoustic neuroma. Disruption of the central pathways compensating for a peripheral imbalance, increased neuronal excitability, changes in intracranial pressure, and metabolic changes on cerebellar calcium channels are potential mechanisms for the generation of HIN. The Valsalva maneuver may also produce vertigo and nystagmus in patients with craniocervical junction anomalies, perilymph fistula, and canal dehiscence syndromes. Presumably, Valsalva maneuver increases intracranial or tympanic pressure and exerts force directly at the site of the fistula or dehiscence, causing deflection of the cupula of the involved semicircular canal.