Kantor Ireneusz, Jurkiewicz Dariusz
Wojskowy Instytut Medyczny w Warszawie, Klinika Otolaryngologiczna CSK MON.
Pol Merkur Lekarski. 2006 Mar;20(117):318-21.
Comprehensive medical history and videonystagmography (VNG) testing play very important role in balance assessment especially when dealing with balance disorders occurring occasionally. VNG in many clinical situations is performed as an initial test before complete otoneurological examination is carried out. Betahistine dihydrochloride (betahistine) a synthetic histamine analogue is one of many drugs used in the treatment of balance disorders of central or peripheral etiology. The aim of our work was to analyze, using the VNG test, effectiveness of betahistine treatment and to compare it with the control group treated with different drugs.
42 patients suffering from vertigo were evaluated before and after the treatment with betahistine. Treatment results were compared with the results of 20 vertigo sufferers treated during the same period of time with different drugs. In effort to standardize asked questions, interviews with patients were completed with specially structured questionnaire. In 54% of patients, decreased intensity and severity of vegetative symptoms was observed after the treatment with betahistine, in 45.2% of patients (30% of the control group) decreased frequency of attacks was noted.
In 69.1% of patients treated with betahistine and in 50% of the control group improved results of the VNG test were noted. In 9.5% of patients (4 patients) treated with betahistine and in 20% of patients from the control group, the VNG test results were worse. Quantitative and qualitative features of the VNG test were best improved in parts of the test showing features of its central origin. In 50% of patients improvement of the symmetry in Optokinetic testing, decrease or stop of vertical component of positional nystagmus was noted. In 38.1% of patients decrease of directional predominance of nystagmus in Caloric Testing was noted. None of all examined patients exhibited features of worsening of VNG test results and no new symptoms were noted. Radiological investigations showed no new pathologies.
Betahistine dichloride is one of the basic drugs used in the treatment of vertigo of different etiology.
全面的病史和视频眼震图(VNG)测试在平衡评估中起着非常重要的作用,尤其是在处理偶尔发生的平衡障碍时。在许多临床情况下,VNG在进行全面的耳神经学检查之前作为初始测试进行。倍他司汀二盐酸盐(倍他司汀)是一种合成组胺类似物,是用于治疗中枢性或外周性病因引起的平衡障碍的众多药物之一。我们研究的目的是使用VNG测试分析倍他司汀治疗的有效性,并将其与用不同药物治疗的对照组进行比较。
42例眩晕患者在接受倍他司汀治疗前后进行了评估。将治疗结果与同期20例用不同药物治疗的眩晕患者的结果进行比较。为了使所提问题标准化,对患者的访谈通过专门设计的问卷完成。在用倍他司汀治疗后,54%的患者植物神经症状的强度和严重程度降低,45.2%的患者(对照组的30%)发作频率降低。
在用倍他司汀治疗的患者中,69.1%的患者VNG测试结果改善,对照组为50%。在用倍他司汀治疗的患者中,9.5%(4例患者)和对照组20%的患者VNG测试结果更差。VNG测试的定量和定性特征在显示其中心起源特征的测试部分改善最佳。在50%的患者中,视动测试的对称性改善,位置性眼震的垂直成分减少或停止。在38.1%的患者中,冷热试验中眼震的方向优势减少。所有接受检查的患者均未表现出VNG测试结果恶化的特征,也未发现新的症状。影像学检查未发现新的病变。
倍他司汀二盐酸盐是用于治疗不同病因眩晕的基本药物之一。