Clinical characteristics and therapeutic outcomes of 120 patients with positional down-beat nystagmus (pDBN)…

Cohort studyEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery· Aug 2026

Clinical characteristics and therapeutic outcomes of 120 patients with positional down-beat nystagmus (pDBN) with negative brain MRI.

Le Zhang, Ding Liu, Li Peng … Ru Chen

Read paper

NeuroradiologyCohort studyTreatmentQ2IF 2.5

Continuous down-beat nystagmus responds poorly to repositioning maneuvers, unlike other subtypes

Clinical characteristics and therapeutic outcomes of 120 patients with positional down-beat nystagmus (pDBN) with negative brain MRI.

Le Zhang … Ru Chen

European archives of oto-rhino-laryngology · Aug 2026 · Q2 in General Medicine

Purpose

This study aims to observe the clinical characteristics, nystagmus features, and the effectiveness of repositioning maneuvers (repositioning maneuvers) in patients with DBN and negative brain MRI.

Methods

We conducted a retrospective review of records pertaining to 3,083 vertigo patients, ultimately enrolling 120 of them (3.9%).

n = 19 patients

Results

50.0%

half of continuous down-beat cases improved with maneuvers, the rest did not

n = 19 patients

More results

Most patients with U-DBN exhibited brief-latency (90.9%) transient nystagmus (100%), with a 100% effective rate for repositioning maneuvers (ipsilateral Epley maneuver).

The repositioning maneuvers is effective for single DBN patients, with the contralateral Epley maneuver outperforming the ipsilateral one, with an efficacy rate of 100% versus 66.7-81.3%.

More results

Most patients with mixed beating nystagmus primarily exhibited transient nystagmus (84.4%) and responded well to repositioning maneuvers (ipsilateral Epley maneuver) with a 93.8% effective rate.

“

Conclusion · 1 of 3

Our findings suggest that MRI-negative DBN is not uncommon in vertigo patients.

Conclusion · 2 of 3

U-DBN, single DBN, and mixed beating nystagmus respond favorably to the Epley maneuver, suggesting a close association with benign paroxysmal positional vertigo (benign paroxysmal positional vertigo).

Conclusion · 3 of 3

However, continuous DBN shows a suboptimal response to the Epley maneuver, with its underlying etiology still requiring further elucidation.

Clinical characteristics and therapeutic outcomes of 120 patients with positional down-beat nystagmus (pDBN) with negative brain MRI.

Clinical characteristics and therapeutic outcomes of 120 patients with positional down-beat nystagmus (pDBN) with negative brain MRI.

Related papers