后半规管良性阵发性位置性眩晕患者在体位诱发试验中的眼震特征分析

发布时间：2018-01-02 19:00

本文关键词：后半规管良性阵发性位置性眩晕患者在体位诱发试验中的眼震特征分析　出处：《临床耳鼻咽喉头颈外科杂志》2015年01期 　论文类型：期刊论文

【摘要】：目的:分析和总结后半规管良性阵发性位置性眩晕(BPPV)患者在体位诱发试验中的眼震特点,提高对后半规管BPPV的诊断和治疗。方法:回顾性分析175例确诊为后半规管BPPV患者的视频眼震图资料,分析该类BPPV患者在Dix-Hallpike试验、Roll试验和翻身试验中的眼震特征。结果:175例BPPV患者中,左后半规管BPPV 69例(39.4%),右后半规管BPPV 106例(60.6%)。Dix-Hallpike试验悬头位时,所有患者均记录到垂直向上的眼震,其中扭转成分指向患侧47例(26.9%),指向健侧100例(57.1%),余28例(16.0%)眼震无明显扭转成分;Dix-Hallpike试验坐位时,139例(79.4%)患者可见垂直向下的眼震,其中扭转成分指向患侧40例(22.9%),指向健侧68例(38.9%),无扭转成分者31例(17.7%),余36例(20.6%)患者无明显眼震,仅有短暂眩晕感或头晕感。在Roll试验中,12例右后半规管BPPV患者在头右转时出现带旋转成分的垂直上跳性眼震,5例左后半规管BPPV患者在头左转时出现带扭转成分的垂直上跳性眼震。在翻身试验中,左侧卧位变至右侧卧位时,出现垂直方向眼震的有74例(42.3%),30例上跳性眼震中有25例(83.3%)来自右后半规管BPPV,44例下跳性眼震中有36例(81.8%)来自左后半规管BPPV;在该试验中,垂直眼震方向与判断后半规管的左右侧别密切相关(P0.01)。结论:Dix-Hallpike试验中后半规管BPPV患者的眼震扭转成分方向不定,其诊断主要依据垂直眼震的方向;Roll滚转试验中出现带垂直上跳性成分为主的旋转性眼震,提示后半规管BPPV可能;利用翻身试验可协助左右侧后半规管的定位诊断。
[Abstract]:Objective: to analyze and summarize the characteristics of nystagmus in postpositional induction test in patients with posterior semicircular canal benign paroxysmal positional vertigo (BPPV). To improve the diagnosis and treatment of posterior semicircular canal BPPV. Methods: the video nystagmus data of 175 patients with posterior semicircular canal BPPV were analyzed retrospectively. The characteristics of nystagmus in Dix-Hallpike roll test and roll test were analyzed. Results in 175 cases of BPPV patients, there were 175 cases of BPPV. There were 69 cases of left posterior semicircular canal BPPV and 60.6 cases of right posterior semicircular canal BPPV. Vertical nystagmus was recorded in all the patients. The torsion component was directed to the affected side in 47 cases and to the healthy side in 100 cases (57.1%). In the remaining 28 cases, there was no significant torsional component in the nystagmus. Vertical downward nystagmus was observed in 139 patients (79.4%) in the Dix-Hallpike test. The torsion component was pointed to the affected side in 40 cases (22. 9%). There were 68 cases with normal side, 31 cases with no torsion, and 36 cases with 20. 6%) with nystagmus. In the Roll test, 12 patients with right posterior semicircular canal BPPV had vertical jump nystagmus with rotational components during the right turn. In 5 patients with left posterior semicircular canal BPPV, vertical upbeat nystagmus with torsion was found in the head turn. In the turn over test, the left lateral position changed to the right lateral position. There were 74 cases with vertical nystagmus and 30 cases with nystagmus. 25 cases (83.3%) came from the right posterior semicircular canal (BPPV). 36 cases (81.8%) came from left posterior semicircular canal (BPPV). In this experiment. The direction of perpendicular nystagmus was closely related to the left and right side of posterior semicircular canal. Conclusion the direction of nystagmus torsion in patients with posterior semicircular canal BPPV in the 1: Dix-Hallpike test is uncertain. The diagnosis is mainly based on the direction of vertical nystagmus. Rotational nystagmus with vertical jumping component was found in Roll rolling test, which suggested that BPPV in posterior semicircular canal might be possible. The use of the rollover test can assist in the localization of the left and right posterior semicircular canals.
【作者单位】：中南大学湘雅医院耳鼻咽喉头颈外科;上海交通大学医学院附属仁济医院耳鼻咽喉头颈外科;
【基金】：国家自然科学基金(No:81170923,No:81260160) 湖南省科技计划项目院士基金(No:2013FJ4110)
【分类号】：R764.3
【正文快照】： 良性阵发性位置性眩晕(benign paroxysmal po-sitional vertigo,BPPV)是最常见的前庭外周性眩晕,是一种头位改变到某一特定位置时诱发的短暂眩晕。BPPV的发病机制围绕着管石症学说和嵴帽结石学说得到了广泛认可,但有关的病理机制并不十分清楚,病因也不甚明确〔1〕。目前国内外

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