Department of Neurology, University Hospital Zurich ; Department of Ophthalmology, University Hospital Zurich ; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich.
Department of Neurology, University Hospital Zurich ; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
Clin Interv Aging. 2014 Apr 8;9:589-91. doi: 10.2147/CIA.S58785. eCollection 2014.
Dizziness in the elderly is a serious health concern due to the increased morbidity caused by falling. The most common cause of dizziness in the elderly, benign paroxysmal positional vertigo (BPPV), is frequently undiagnosed, and bedside treatment of these patients can be difficult due to neck and back stiffness, which makes repeated and accurate repositioning maneuvers difficult.
After a fall, a 96-year-old woman was referred by a resident neurologist for intractable BPPV. The patient was placed on a motorized turntable and repositioned to remove the calcite particles from the affected posterior semicircular canal. Video monitoring of the eyes allowed confirmation of the diagnosis, as well as an immediate evaluation of the effectiveness of the maneuver.
Every patient with dizziness or imbalance, even in the absence of typical complaints of BPPV, should be tested with provocation maneuvers, because the clinical picture of BPPV is not always typical. Even if elderly patients with dizziness are very frail, the completion of provocation maneuvers is imperative, since the therapeutic maneuvers are extremely effective. A motorized turntable is very helpful to perform the repositioning accurately and safely.
老年人头晕是一个严重的健康问题，因为跌倒会导致发病率增加。老年人最常见的头晕原因是良性阵发性位置性眩晕（BPPV），但这种疾病经常被漏诊，而且由于颈部和背部僵硬，这些患者的床边治疗可能很困难，因为这使得重复和准确的复位操作变得困难。
一位 96 岁的女性在跌倒后，由住院神经内科医生转介来院，因顽固性 BPPV 就诊。患者被放置在电动转台上，并进行体位复位，以清除受影响的后半规管中的碳酸钙颗粒。眼睛的视频监测可以确认诊断，并立即评估操作的效果。
即使没有典型的 BPPV 症状，每个头晕或失衡的患者都应该进行诱发试验，因为 BPPV 的临床表现并不总是典型的。即使是非常虚弱的老年头晕患者，也必须完成诱发试验，因为治疗性的复位操作非常有效。电动转台非常有助于准确和安全地进行复位。
