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Labyrinthine positional nystagmus (LPN) is a condition characterized by abnormal eye movements, specifically nystagmus, that occur in response to changes in head position. Here's a breakdown of its symptoms, diagnosis, and treatment.

1. Nystagmus: In LPN, nystagmus occurs when the head is moved into certain positions. This nystagmus can be horizontal, vertical, or torsional.
2. Dizziness: Patients often experience vertigo or a spinning sensation when they change head positions.
3. Imbalance: Difficulty maintaining balance, especially when moving the head.
4. Nausea and vomiting: Some patients may experience these symptoms due to the vertigo.

1. Canalith repositioning maneuvers: If LPN is caused by displaced otoliths (calcium carbonate crystals) in the inner ear, maneuvers like the Epley maneuver or Semont maneuver can help reposition them, alleviating symptoms.
2. Vestibular rehabilitation therapy (VRT): This therapy involves specific exercises to improve balance and reduce dizziness by promoting central nervous system compensation for vestibular dysfunction.
3. Medications: In some cases, medications such as vestibular suppressants (e.g., meclizine, benzodiazepines) may be prescribed to alleviate symptoms like vertigo and nausea.
4. Surgery: In rare cases where LPN is caused by structural abnormalities in the inner ear, surgical intervention may be necessary.

1. Clinical history and examination: The doctor will start by taking a detailed history of the patient's symptoms and performing a physical examination, including a neurological examination and assessment of eye movements.
2. Dix-Hallpike maneuver: This test is commonly used to diagnose benign paroxysmal positional vertigo (BPPV), but it can also help diagnose LPN. It involves moving the patient's head into specific positions to elicit nystagmus.
3. Head impulse test (HIT): This test assesses the vestibulo-ocular reflex (VOR) by quickly moving the patient's head while they focus on a target. Abnormal findings can indicate dysfunction in the labyrinthine system.
4. Electronystagmography (ENG) or videonystagmography (VNG): These tests measure eye movements using electrodes or cameras, respectively, and can help quantify nystagmus and identify its characteristics.
5. Caloric testing: This test involves irrigating the ear canal with warm and cold water to stimulate the vestibular system. It can help assess the function of each inner ear separately.