Wu Zhi-ping, Zhou Bo, Chen Hai-bo, Jiang Lei
Department of Neurology, Clinical Division of South Building, Chinese PLA General Hospital, Beijing 100853, China.
Zhonghua Nei Ke Za Zhi. 2010 Jul;49(7):599-601.
To analyze the characteristics of benign paroxysmal positional vertigo (BPPV) and the efficacy and safety of Epley's maneuver in very old patients.
A retrospective review of 29 (16.5%) patients with BPPV out of 176 consecutively admitted patients aged 80 and over presented with a complaint of dizziness was performed.
In all 29 patients the BPPV origin was attributed to posterior canal involvement; 24 (82.8%) were idiopathic, 4 with a history of Ménière's disease, and 1 secondary to head trauma; 18 (62.1%) were right-side involved; and 25 (86.2%) were diagnosed previously as vertebral-basilar insufficiency. Cardio- and cerebrovascular diseases and the correlative risk factors were common both in patients with BPPV and those with non-BPPV dizziness. Twenty-one patients underwent Epley's maneuver, all were free of vertigo after treatment, 14 of them after a single session and the remaining 2 to 4 sessions. No significant complications were observed except in one who experienced vomiting during the procedure. Patients who received Epley's maneuver had a higher cure rate and short recovery time than those who did not.
BPPV is not uncommon in very old patients with dizziness. Clinicians should have the knowledge to diagnose and treat this condition. Epley's maneuver is safe and effective in very old patients with BPPV.
分析老年患者良性阵发性位置性眩晕（BPPV）的特点以及Epley手法复位的有效性和安全性。
回顾性分析176例连续收治的80岁及以上因头晕入院患者中的29例（16.5%）BPPV患者。
29例患者BPPV均起源于后半规管受累；24例（82.8%）为特发性，4例有梅尼埃病病史，1例继发于头部外伤；18例（62.1%）为右侧受累；25例（86.2%）既往被诊断为椎基底动脉供血不足。BPPV患者与非BPPV头晕患者的心血管和脑血管疾病及相关危险因素均较为常见。21例患者接受了Epley手法复位，治疗后所有患者眩晕消失，其中14例单次复位后缓解，其余2至4次复位后缓解。除1例在操作过程中出现呕吐外，未观察到明显并发症。接受Epley手法复位的患者治愈率更高，恢复时间更短。
BPPV在老年头晕患者中并不少见。临床医生应具备诊断和治疗该病的知识。Epley手法复位对老年BPPV患者安全有效。
