Thakar A, Deka R C
Department of Otolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, 110029 New Delhi.
Indian J Otolaryngol Head Neck Surg. 2000 Apr;52(2):128-32. doi: 10.1007/BF03000329.
Thirteen consecutive cases wherein Benign Paroxysmal Positional Vertigo was diagnosed are retrospectively reviewed. The Dix-Hallpike positioning test was classically positive with a typical torsional, down beating, transient nystagmus in four of these thirteen cases. The diagnosis in the other nine was based on a suggestive history with or without subjective vertigo on the positioning test. Ten cases improved with labyrinthine suppressants and habituation exercises alone. This included all the patients wherein the Dix-Hallpike maneouvre did not elicit any nystagmus. However, in the group wherein the Dix-Hallpike maneouvre resulted in nystagmus, only one of the four improved and the particle repositioning maneouvre (PRM) was employed in the three cases with persistent symptoms. Two had immediate relief of symptoms. The particle repositioning maneouvre was repeated after three days in the one other patient and proved successful on this second occasion. Surgical treatment was not necessitated in any case, It is proposed that the particle repositioning maneouvre should be the preferred first-line treatment for any patient who on Dix-Hallpike testing demonstrates nystagmus typical of BPPV.
回顾性分析了连续13例被诊断为良性阵发性位置性眩晕的病例。在这13例病例中，有4例Dix-Hallpike位试验呈典型阳性，伴有典型的扭转性、向下跳动性、短暂性眼球震颤。其他9例的诊断基于提示性病史，定位试验时有或无主观眩晕。10例仅通过使用迷路抑制药和习服训练得到改善。这包括所有Dix-Hallpike手法未引出任何眼球震颤的患者。然而，在Dix-Hallpike手法导致眼球震颤的组中，4例中只有1例改善，3例有持续症状的患者采用了颗粒复位手法（PRM）。2例症状立即缓解。另1例患者在3天后重复颗粒复位手法，第二次成功。所有病例均无需手术治疗。建议对于任何在Dix-Hallpike试验中表现出典型良性阵发性位置性眩晕眼球震颤的患者，颗粒复位手法应作为首选的一线治疗方法。
