摘要
目的探讨良性阵发性位置性眩晕复位成功后残余症状的持续时间及可能病因。方法纳入2016年10月至2017年1月就诊于第二军医大学长征医院神经内科的原发性良性阵发性置性眩晕且复位成功的60例患者,对其中存在残余症状患者的视觉模拟量表(VAS)评分、医院焦虑抑郁量表(HADS)评分、主观视觉垂直线(SVV)和眼肌前庭诱发肌源性电位(o VEMP)进行记录,随访并记录残余症状持续时间。按残余症状持续时间将患者分为短时组(残余症状持续时间≤7 d)和长时组(残余症状持续时间>7 d),比较2组患者上述临床指标的差异。结果复位成功后存在残余症状的患者有36例(60.00%),其中22例(61.11%)患者在1周内自发缓解,14例残余症状持续时间超过1周。短时组患者复位后当日的VAS评分和HADS评分均低于长时组(P均<0.05),SVV反方向偏斜发生率高于长时组[63.6%(14/22)vs 28.6%(4/14),χ~2=4.21,P=0.04],而2组的o VEMP异常率差异无统计学意义。结论复位成功后短暂的耳石器功能障碍和中枢再调定延迟参与了BPPV残余症状的发生,但其主观头晕症状较轻、持续时间较短。持续时间超过1周的残余症状多与精神情绪因素相关。
Objective To explore the duration of residual dizziness after successful canalith repositioning maneuvers in patients with benign paroxysmal positional vertigo（BPPV） and the possible causes. Methods A total of 60 BPPV patients with successful canalith repositioning maneuver were recruited from Department of Neurology of Changzheng Hospital of Second Military Medical University from Oct. 2016 to Jan. 2017. Visual Analogue Scale（VAS）, Hospital Anxeity and Depression Scale（HADS）, subjective visual vertical（SVV） and ocular vestibular evoked myogenic potential（o VEMP） were evaluated in the BPPV patients suffering from residual dizziness after successful canalith repositioning maneuvers, and their residual dizziness duration was recorded. According to the residual dizziness duration, the patients were divided into shortterm group（≤7 d） and long-term group（7 d）, and the difference of clinical characteristics was analyzed. Results There were 36（60.00%） BPPV patients with residual dizziness after successful canalith repositioning maneuver, and 22（61.11%） cases recovered within 1 week, and 14 lasted for more than 1 week. Compared with the long-term group, VAS and HADS scores were significantly lower（all P0.05） and reverse deviation incidence of SVV were higher in the short-term group（63.6% [14/22] vs 28.6% [4/14], χ~2=4.21, P=0.04）. There was no significant difference in o VEMP abnormality rate between the two groups. Conclusion The transient otolithic dysfunction and central readaption play a role in the occurrence of residual dizziness of the BPPV patients after successful canalith repositioning maneuver, and the residual dizziness usually has mild symptoms and a shorter duration. The residual dizziness with a duration longer than 7 days is associated with mental and emotional factors.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2018年第2期216-219,共4页
Academic Journal of Second Military Medical University
关键词
良性阵发性位置性眩晕
残余症状
持续时间
前庭肌源诱发电位
benign paroxysmal positional vertigo
residual dizziness
duration
vestibular evoked myogenic potential
