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Report of childhood
positional vertigo is very rare. We present a 7-year-old boy who revealed persistent
direction-changing geotropic positional nystagmus. In the supine position,
horizontal nystagmus toward the left continued as long as
the position was maintained. However, it ceased when the head was turned to the
right side by 45°. With greater head
turn (right-ear-down), nystagmus toward the right lasted for more than 1
minute. In the left-ear-down position, horizontal nystagmus
toward the left occurred and lasted for more than 1 minute. After the disappearance
of positional nystagmus, we detected canal paresis of
the right ear by caloric test. We considered that the pathophysiology of the
persistent type of geotropic nystagmus is a result of light debris cupulolithiasis
of the horizontal canal.
Objective: To determine if current peer-reviewed literature supports the existence of a relationship between the administration of dietary supplements containing 5-Aminolevulinic Acid (5-ALA) and sleep. Methods: Conceptual analysis of a systematically defined group of data is based on publications in referred journals. Constant comparative analyses were used to analyze the data. Detailed analyses were used to identify trends that led to qualifying relationships between the use of 5-ALA and heme. In addition, the relationship among heme, melatonin, and sleep were explored. Since there were no published data related to 5-ALA and sleep, an analysis of what is known about 5-ALA and heme was undertaken. Results: Currently, within the scope of this review, no literature available directly connecting 5-ALA and sleep was found. Research indicates that 5-ALA has an indirect relationship with intra-cellular energy production, which could result in a wide range of effects fromcellular to endocrine to neurologic to behavioral. In addition, there is evidence that 5-ALA may influence tryptophan and serotonin levels. Conclusion: While there are no studies on 5-ALA and sleep were found, current research suggests several potential mechanisms by which 5-ALA could influence sleep. The mechanisms suggest the potential for 5-ALA to assist in the adjustment of a person’s circadian cycle, endocrine function, or neurologic function in order to allow for better sleep in a natural way. In doing so, it may provide for a safer alternative to currently available sleep medication. Further research is needed to explore this possibility.