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。
Objective To study the diagnosis and treatment of posterior semicircular canal combined with an- other canal benign paroxysmal positional vertigo. Methods All posterior semicircular canal combined with another canal benign paroxysmal positional vertigo patients were tested with Dix--Hallpike test, and the nystagmus was re- corded by VNG. Epley maneuver was used to treat the posterior semicircular canal for the side with more intensive nystagmus. Results Nystagmus before treatment： thirty--nine patients had：both sides upbeating torsional nystag- mus, thirteen patients had one side upbeating torsional nystagmus with downbeating torsional nystagmus in the oth- er side and fifteen patients had one side upbeating torsional nystagmus with horizontal nystagmus in the other side. Most patients had one side intensive upbeating torsional nystagmus with lower amplitude nystagmus on the other side. Nystagmus after treatment： thirty--six patients who had both sides upbeating torsional nystagmus were cured, thirteen patients who had one sides upbeating torsional nystagmus with downbeating torsional nystagmus on the other side were cured, and fouteen patients who had one sides upbeating torsional nystagmus with horizontal nystagmus on the other side were cured. Conclusion Although most patients with diagnosed posterior semicircular canal combined another canal benign paroxysmal positional vertigo had both--side upbeating torsional nystagmus,they in fact should be diagnosed one side PSC--BPPV, while the nother side as pseudo--BPPV. Most of the pa- tients with posterior semicircular canal combined with another canal benign paroxysmal positional vertigo had one side intensive upheating torsional nystagmus with lower amplitude nystagmus on the other side. Epley maneuver should be used to treat the posterior semicircular canal for the side with more intensive nystagmus.
出处
《听力学及言语疾病杂志》
CAS
CSCD
北大核心
2013年第2期112-114,共3页
Journal of Audiology and Speech Pathology
关键词
良性阵发性位置性眩晕
半规管
治疗
Benign paroxysmal positional vertigo
Semicircular canal
Treatment
