Gámiz Maria J, Lopez-Escamez Jose A
Division of Otorhinolaryngology, Department of Surgery, Hospital de Poniente, El Ejido, Almería, Spain.
Gerontology. 2004 Mar-Apr;50(2):82-6. doi: 10.1159/000075558.
Benign paroxysmal positional vertigo (BPPV) is a common cause of dizziness within the geriatric population causing disability. The diagnosis is established by the position-induced rotatory nystagmus, related to the involved ear, demonstrated by the Dix-Hallpike test (DHT). Although the Epley's modified manoeuvre, or particle respositioning manoeuvre (PRM), is an effective treatment for this disorder, its impact on health outcome in patients over 60 years old is unknown.
To assess BPPV health-related quality of life in elderly individuals using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and the Dizziness Handicap Inventory Short Form (DHI-S).
A prospective study including new cases of BPPV in patients older than 60 years was carried out. The diagnosis was based on the history of recurrent sudden crises of vertigo and a typical positional-induced nystagmus during the DHT. All patients were treated by a single PRM and relapses were investigated a the 30th post-treatment day.
DHT was found negative in 82% (23/28) individuals at 30 days. The eight scales of the SF-36 have a good internal consistency reliability in patients with BPPV (Cronbach's alpha > 0.7). The average standardized score for each SF-36 scale was compared with the reference population normative data, showing differences with norms for role physical, body pain, social function, role emotional and mental health. After PRM, patients restored scores to norms, showing a significant increase in role physical (p < 0.05), body pain (p < 0.04), vitality (p < 0.02), social function (p < 0.003) and mental health scores (p < 0.005). DHI-S total score significantly decreased from 17.19 +/- 9.06 (mean +/- SD) at the first day to 9.70 +/- 10.13 at 30 days (p < 0.001).
BPPV has a significant impact on health-related quality of life in elderly patients on their emotional and physical states compared to those unaffected. The PRM can restore health-related quality of life in elderly patients with BPPV.
良性阵发性位置性眩晕（BPPV）是老年人群中导致残疾的常见头晕原因。通过Dix-Hallpike试验（DHT）所证实的、与患侧耳相关的位置性旋转性眼震来确立诊断。尽管Epley改良手法，即颗粒复位手法（PRM），是治疗该疾病的有效方法，但其对60岁以上患者健康结局的影响尚不清楚。
使用医学结局研究简明健康调查问卷（SF-36）和头晕残障量表简表（DHI-S）评估老年个体中与BPPV相关的健康状况。
开展一项前瞻性研究，纳入60岁以上的BPPV新发病例。诊断基于眩晕反复发作的病史以及DHT期间典型的位置性诱发眼震。所有患者均接受单次PRM治疗，并在治疗后第30天调查复发情况。
30天时，82%（23/28）的个体DHT结果为阴性。SF-36的八个维度在BPPV患者中具有良好的内部一致性信度（Cronbach's α>0.7）。将每个SF-36维度的平均标准化得分与参考人群的常模数据进行比较，结果显示在角色身体功能、身体疼痛、社会功能、角色情感和心理健康方面与常模存在差异。PRM治疗后，患者的得分恢复至常模水平，角色身体功能（p<0.05）、身体疼痛（p<0.04）、活力（p<0.02）、社会功能（p<0.003）和心理健康得分（p<0.005）均显著提高。DHI-S总分从第一天的17.19±9.06（均值±标准差）显著降至30天时的9.70±10.13（p<0.001）。
与未受影响的患者相比，BPPV对老年患者的情绪和身体状态下与健康相关的生活质量有显著影响。PRM可恢复老年BPPV患者与健康相关的生活质量。
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