摘要
目的探讨儿童复发性眩晕(recurrent vertigo of childhood,RVC)患者的临床特点、预后情况及衍变为儿童前庭性偏头痛的可能风险因素。方法回顾性分析2018年1月—2019年6月在上海交通大学医学院附属新华医院听力障碍及眩晕诊治中心就诊的41例诊断为RVC患儿的临床资料,包括眩晕情况、听力检查、前庭功能检查、相关家族史等。通过电话或现场问卷对患儿及家属进行随访调查,采集患儿的预后情况及影响预后转归的可能风险因素。结果41例患儿男22例,女19例;年龄7~17岁,初次发作年龄3~14岁。发作频率每周1次至每天数次,持续数分钟至数天不等,多例患儿(39%)报告有晕车史,与发作相关的较频繁的体征为恶心呕吐(34%)。眼震视图检查异常3例,冷热实验异常4例,颈源性前庭诱发肌源电位异常1例,视频头脉冲实验异常3例。41例患者患儿中有30例完成了随访调查,其中21例症状消失,8例仍存在眩晕或头晕症状,但较初次发病均已有好转,另有1例出现了偏头痛,经过询问得知该患者日常学习压力较大。结论RVC患儿眩晕发作不伴随听力下降等耳部症状,但可能存在前庭功能异常,并且多数患儿眩晕症状随年龄增长有自愈倾向,但部分患儿会衍变为偏头痛,饮食习惯和生活学习压力可能是RVC衍变为偏头痛的风险因素。
Objective To investigate the clinical characteristics,prognosis of Recurrent Vertigo of Childhood(RVC)and explore the possible risk factors for the evolution of RVC into vestibular migraine of children.Methods 41 patients diagnosed as RVC at the Hearing Disorder and Vertigo Center of Xinhua Hospital Affiliated to Shanghai Jiaotong University school of medicine from January 2018 to June 2019.20 children were diagnosed as definite RVC,and 21 children were dianosed with probable RVC.Questionnaire surveies were conducted using face-to-face or telephone method,and the prognosis of these BPVC children was recorded and the possible prognostic risk factors were analyzed.Results There were 22 males and 19 females in 41 cases.The age is 7~17 years old,and the age of first attack is 3~14 years old.The frequency of attacks ranged from once a week to several times a day,and the duration attacks from a few minutes to a few days.Many children(39%)reported a history of carsickness,and the more frequent physical sign associated with seizures was nausea and vomiting(34%).There were 3 cases of abnormal nystagmus,4 cases of abnormal hot and cold test,1 case of abnormal c-Vestibular-Evoked Myogenic Potentials and 3 cases of abnormal video-Head Impulse Test.Among the 41 patients,30 completed the follow-up survey,21 patients'symptoms disappeared,and 8 patients still had symptoms of vertigo or dizziness,but they had improved from the initial onset.One patient had a migraine,and the interrogation showed that the patient was under more stress in daily study.Conclusion Vertigo attack in RVC is not accompanied by hearing loss and other ear symptoms,but there may be vestibular dysfunction,and most of the vertigo symptoms tend to heal with age,but some children will develop migraines.Eating habits and stress of life and learning may be the risk factors for RVC to migraine.
作者
林珂瑜
陈建勇
沈佳丽
马孝宝
张勤
王璐
肖永涛
LIN Keyu;CHEN Jianyong;SHEN Jiali;MA Xiaobao;ZHANG Qin;WANG lu;XIAO Yongtao(School of Medical Teachnology and Information Engineering of Zhejiang Chinese Medical University,Zhejiang Hangzhou,310053;Department of Otolaryngology Head&Neck Surgery,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,200092)
出处
《中华耳科学杂志》
CSCD
北大核心
2023年第6期848-853,共6页
Chinese Journal of Otology
关键词
儿童复发性眩晕
预后
风险因素
前庭性偏头痛
recurrent vertigo of childhood
prognosis
risk factors
vestibular migraine
