Ahn Seong-Ki, Jeon Sea-Yuong, Kim Jin-Pyeong, Park Jung Je, Hur Dong Gu, Kim Dae-Woo, Woo Seung-Hoon, Kwon Oh-Jin, Kim Jin-Yong
Department of Otolaryngology, School of Medicine, Gyeongsang National University, Jinju, South Korea.
J Trauma. 2011 Feb;70(2):442-6. doi: 10.1097/TA.0b013e3181d0c3d9.
Traumatic brain injury (TBI) has been reported to be a common cause of benign paroxysmal positional vertigo (BPPV). However, only a few studies have investigated BPPV after TBI. The aim of this study was to identify the clinical characteristics of BPPV after TBI and to determine whether there are clinical differences between BPPV after TBI and idiopathic BPPV.
The authors reviewed the medical records of 192 consecutive patients with positional vertigo after head injury during the period 2003 to 2009 and investigated 112 patients with idiopathic BPPV treated over the same period. The clinical characteristics of BPPV after TBI and the clinical differences between the traumatic BPPV and idiopathic BPPV groups were investigated.
A total of 32 patients with BPPV after TBI fulfilled the inclusion criteria. Twenty-four patients in the traumatic BPPV group had posterior semicircular canal-BPPV and 11 patients lateral semicircular canal-BPPV. A total of 58 repositioning maneuver sessions were performed in these 32 patients. Members of the traumatic BPPV group required more treatment sessions than members of the idiopathic group (p<0.05), but no tendency to recur was observed in the traumatic group (p>0.05). Recurrence rates in the traumatic and idiopathic BPPV groups were 15.6% and 18.8%, respectively (p>0.05).
It is likely that BPPV after TBI is more difficult to treat than idiopathic BPPV, but no tendency to recur was observed in patients who developed BPPV after TBI compared with idiopathic BPPV. Further prospective clinical meta-analytic studies are needed to investigate the outcome of BPPV after TBI.
据报道，创伤性脑损伤（TBI）是良性阵发性位置性眩晕（BPPV）的常见病因。然而，仅有少数研究对TBI后的BPPV进行过调查。本研究的目的是确定TBI后BPPV的临床特征，并判断TBI后BPPV与特发性BPPV之间是否存在临床差异。
作者回顾了2003年至2009年间192例头部受伤后出现位置性眩晕的连续患者的病历，并调查了同期治疗的112例特发性BPPV患者。研究了TBI后BPPV的临床特征以及创伤性BPPV组与特发性BPPV组之间的临床差异。
共有32例TBI后BPPV患者符合纳入标准。创伤性BPPV组中24例为后半规管BPPV，11例为水平半规管BPPV。这32例患者共进行了58次复位手法治疗。创伤性BPPV组患者所需的治疗次数比特发性组患者多（p<0.05），但创伤性组未观察到复发倾向（p>0.05）。创伤性和特发性BPPV组的复发率分别为15.6%和18.8%（p>0.05）。
TBI后的BPPV可能比特发性BPPV更难治疗，但与特发性BPPV相比，TBI后发生BPPV的患者未观察到复发倾向。需要进一步进行前瞻性临床荟萃分析研究，以调查TBI后BPPV的转归情况。
