Martens Camilla, Goplen Frederik Kragerud, Nordfalk Karl Fredrik, Aasen Torbjørn, Nordahl Stein Helge Glad
National Competence Service for Vestibular Disorders, Department of Otorhinolaryngology, Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
National Competence Service for Vestibular Disorders, Department of Otorhinolaryngology, Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.
Otolaryngol Head Neck Surg. 2016 May;154(5):861-7. doi: 10.1177/0194599816629640. Epub 2016 Feb 23.
In clinical practice, patients are often referred due to a finding of positional nystagmus that does not always appear to correlate with clinical symptoms of benign paroxysmal positional vertigo. To know when to consider nystagmus to be of clinical relevance, it is necessary to know the prevalence and characteristics of positional nystagmus in a healthy population.
Case series of 75 healthy subjects.
Two tertiary referral centers in Norway.
Seventy-five adult subjects aged 40 ± 13 years (mean ± SD; range, 21-87) without a history of vertigo or balance disorder were included from 2013 to 2015. The subjects underwent 6 different standardized positional tests in a repositioning chair. Videonystagmography was used to record eye movements. Of 1350 recordings, 1329 were included and analyzed.
Positional nystagmus was detected in 88% of the subjects. The most common finding was nystagmus in the Dix-Hallpike position, which occurred in 55% of the subjects. The 95th percentile of the maximum slow-phase velocity for each subject was found to be 5.06° per second (n = 54) in the horizontal plane and 6.48° per second (n = 48) in the vertical plane.
Positional nystagmus is a common finding in normal subjects and occurred in 88% of the healthy subjects in the present study. Horizontal direction-changing apogeotropic or geotropic nystagmus may occur in asymptomatic subjects. However, nystagmus that is of the paroxysmal type or has a slow-phase velocity greater than approximately 5° per second in the horizontal plane or 6.5° per second in the vertical plane should be considered outside the 95th percentile.
在临床实践中，患者常因发现位置性眼球震颤而前来就诊，但其似乎并不总是与良性阵发性位置性眩晕的临床症状相关。为了明确何时应将眼球震颤视为具有临床相关性，有必要了解健康人群中位置性眼球震颤的患病率及特征。
75名健康受试者的病例系列研究。
挪威的两个三级转诊中心。
纳入2013年至2015年期间75名年龄为40±13岁（均值±标准差；范围21 - 87岁）且无眩晕或平衡障碍病史的成年受试者。受试者在复位椅上接受6种不同的标准化位置测试。采用视频眼震图记录眼动。在1350次记录中，纳入并分析了1329次。
88%的受试者检测到位置性眼球震颤。最常见的发现是Dix - Hallpike位置出现眼球震颤，55%的受试者出现此情况。发现每个受试者最大慢相速度的第95百分位数在水平面为每秒5.06°（n = 54），在垂直面为每秒6.48°（n = 48）。
位置性眼球震颤在正常受试者中很常见，在本研究中88%的健康受试者出现。无症状受试者可能出现水平方向改变的背地性或向地性眼球震颤。然而，阵发性类型的眼球震颤或在水平面慢相速度大于约每秒5°或在垂直面大于每秒6.5°的眼球震颤应被视为超出第95百分位数。
