后半规管并其他半规管良性阵发性位置性眩晕诊治分析

Analysis of Posterior Semicircular Canal Combined Another Canal Benign Paroxysmal Positional Vertigo

王利一;高波;黄魏宁;

1:卫生部北京医院耳鼻咽喉科

摘要
目的探讨后半规管合并其他半规管良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的诊断和治疗。方法对67例后半规管合并其他半规管BPPV患者行Dix-Hallpike试验,所有患者选择眼震强度强的一侧后半规管采用Epley管石复位法治疗,每隔3天复查,直至该侧扭转上跳眼震消失,并观察对侧眼震消失情况。结果①治疗前眼震:双侧诱发出扭转上跳眼震39例(双侧后半规管BPPV),一侧诱发出扭转上跳另一侧出现扭转下跳眼震13例(后半规管并前半规管BPPV),一侧诱发出扭转上跳眼震,另一侧出现水平眼震15例(后半规管并外半规管或前半规管BPPV)。大多数患者对侧眼震强度均明显弱于患侧扭转上跳性眼震,只有3例双侧扭转上跳眼震的患者双侧眼震强度基本相同。②治疗后眼震:39例双侧后半规管BPPV患者中36例眼震消失,13例后半规管并前半规管BPPV患者眼震消失,15例后半规管并外半规管或前半规管BPPV患者中14例眼震消失,仅1例残留水平眼震。结论后半规管并其他半规管BPPV患者的眼震以双侧扭转上跳性最多,但对侧多数是假性后半规管BPPV;其次是一侧扭转上跳眼震并另一侧水平眼震和一侧扭转上跳眼震并另一侧扭转下跳眼震,但是对侧眼震强度大多数弱于患侧;治疗后半规管并其他半规管BPPV的患者时应先治疗眼震强度强的一侧后半规管。
关键词
良性阵发性位置性眩晕;半规管;治疗
基金项目(Foundation):
作者
王利一;高波;黄魏宁;
参考文献

1 Korres S,Balatsouras DG,Kaberos A,et al.Occurrence of semicircular canal involvement in benign paro-xysmal position-al vertigo[J].Oto Neurotol,2002,23:926.

2 Emmanuel P,Prokopakis,Theognosia C,et al.Benign parox-ysmal positional vertigo:10year experience in treating 592pa-tients with canalith repositioning procedure[J].Laryngo-scope,2005,115:1 667.

3中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科学分会.良性阵发性位置性眩晕的诊断依据和疗效评估(2006年,贵阳)[J].中华耳鼻咽喉头颈外科杂志,2007,42:163.

4 Dix MR,Hallpike CS.Pathology,symptomatology and diag-nosis of certain disorders of the vestibular system[J].Proc R Soc Med,1952,45:341.

5 Epley JM.Human experience with canalith repositioning ma-neuvers[J].Ann NY Acad Sci,2001,942:179.

6 Korres SG,Balatsouras DG,Papouliakos S,et al.Benign pa-roxysmal positional vertigo and its management[J].Med Sci Monit,2007;13:CR 275.

7 Lopez-Escamez JA,Molina MI,Gamiz M,et al.Multiple positonal nystagmus suggests multiple canal involvement in be-nign paroxysmal positional vertigo[J].Acta Otolaryngol,2005,125:954.

8 Steddin S,Brandt T.Unilateral mimicking bilateral benign paroxysmal positional vertigo[J].Arch Otolaryngol Head Neck Surg,1994,120:1 339.

9 Pollak L,Stryjer R,Kushnir M,et al.Approach to bilateral benign paroxysmal positional vertigo[J].Am J Otolaryngol,2006,27:91.

10 Imai T,Takeda N,Sato G,et al.Differential diagnosis of true and pseudo-bilateral benign paroxysmal positional nys-tagmus[J].Acta Otolaryngol,2008,128:151.

11 Schratzenstaller B,Wagner-Manslau C,Strasser G,et al.Canalolithiasis of the superior semicircular canal:an anomaly in benign paroxysmal positional vertigo[J].Acta Otolaryn-gol,2005,125:1 055.

12 Bertholon P,Faye MB,Tringali S,et al.Benign paroxysmal po-sitional vertigo of horizontal canal.Clincal features in 25patients[J].Ann Otolaryngol Chir Gervicofac,2002,119:73.

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