前半规管良性阵发性位置性眩晕患者的诊断和治疗分析

高金颖;马瑞

神经损伤与功能重建 ›› 2020, Vol. 15 ›› Issue (4) : 207-209.

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神经损伤与功能重建 ›› 2020, Vol. 15 ›› Issue (4) : 207-209.
论著

前半规管良性阵发性位置性眩晕患者的诊断和治疗分析

  • 高金颖,马瑞
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Diagnosis and Treatment of Anterior Canal Benign Paroxysmal Positional Vertigo

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摘要

目的:探讨前半规管良性阵发性位置性眩晕(anterior canal benign paroxysmal positional vertigo, AC-BPPV)患者的眼震和管型受累特征。方法:回顾性收集AC-BPPV患者20例的临床资料,在眼震视图下 行Dix-Hallpike试验,根据其眼震特征对其诊断,并采用Yacovino法对其进行手法复位治疗。结果:①本组 20例患者中,左侧前半规管受累10例(50.0%),右侧前半规管受累5例(25.0%),侧别不能明确判定者5例 (25.0%)。②眼震特征:Dix-Hallpike 试验:单侧下跳性眼震 11 例(55.0%),单侧下跳伴扭转性眼震 1 例 (5.0%),双侧下跳性眼震5例(25.0%),一侧下跳、另一侧下跳伴扭转性眼震2例(10.0%),双侧扭转伴下跳 性眼震 1 例(5.0%)。坐起时出现眼震逆转 5 例(25.0%)。③Yacovino 手法复位:首次手法复位治愈 12 例 (60.0%),有效7例(35.0%),无效1例(5.0%)。1周后复查痊愈15例(75.0%),有效4例(20.0%),无效1例 (5.0%)。结论:AC-BPPV患者在Dix-Hallpike试验中诱发出的眼震多样,单侧多见。多数为下跳眼震不伴 有扭转成分,部分患者双侧Dix-Hallpike试验均能诱发出眼震;Yacovino法手法复位治疗常常效果较好。

Abstract

To investigate the nystagmus and affected canal features of anterior canal benign paroxysmal positional vertigo (AC-BPPV). Methods: A retrospective analysis was performed on 20 patients with AC-BPPV. All patients were diagnosed based on the presence of nystagmus during the Dix-Hallpike and were treated by Yacovino maneuver. Results: Among the 20 AC-BPPV patients admitted, left anterior semicircular canal was involved in 10 (50.0%) patients, right anterior semicircular canal was involved in 5 (25.0%) patients, and 5 (25.0% ) patients were unclear about the involved semicircular canal. In the Dix-Hallpike test, unilateral down-beating nystagmus (DBN) was observed in 11 patients (55.0%), unilateral DBN with torsional components was observed in 1 patient (5.0%), DBN was observed in 5 patients (25.0%), DBN in one side and DBN with torsional components in the other side was observed in 2 patients (10.0%), and bilateral DBN with torsional components was observed in 1 patient (5.0%). Reversal nystagmus was observed among 5 patients after returning to sitting up position (25.0%). 12 patients (60.0%) and 15 patients (75.0%) were cured by Yacovino maneuver after the first time treatment and one week follow-up, respectively. 7 patients (35.0%) and 4 patients (20.0%) were effectively treated by Yacovino maneuver after the first time treatment and one week follow-up, respectively. And the Yacovino maneuver was ineffective in 1 patient (5.0%) after the first time treatment and one week follow-up. Conclusion: Most of the patients with AC-BPPV showed no occurrence of the torsional component in the DBN nystagmus induced by the Dix-Hallpike test. In some patients, nystagmus could be induced by bilateral Dix-Hallpike test. The effect of Yacovino maneuver is often effective.

关键词

前半规管 / 良性阵发性位置性眩晕 / 眼震 / Yacovino法

Key words

anterior canal

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高金颖;马瑞. 前半规管良性阵发性位置性眩晕患者的诊断和治疗分析[J]. 神经损伤与功能重建. 2020, 15(4): 207-209
Diagnosis and Treatment of Anterior Canal Benign Paroxysmal Positional Vertigo[J]. Neural Injury and Functional Reconstruction. 2020, 15(4): 207-209

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