Nuti D, Masini M, Mandalà M
Department of Otology and Skull Base Surgery, University of Siena, Siena, Italy.
Department of Social, Political and Cognitive Sciences, University of Siena, Siena, Italy.
Handb Clin Neurol. 2016;137:241-56. doi: 10.1016/B978-0-444-63437-5.00018-2.
Benign paroxysmal positional vertigo is a common labyrinthine disorder caused by a mechanic stimulation of the vestibular receptors within the semicircular canals. It is characterized by positional vertigo and positional nystagmus, both provoked by changes in the position of the head with respect to gravity. The social impact of the disease and its direct and indirect costs to healthcare systems are significant owing to impairment of daily activities and increased risk of falls. The first description of a patient with benign paroxysmal positional vertigo is from Robert Bárány in 1921, but the features of the syndrome and the diagnostic maneuver were well described by Dix and Hallpike in 1952. Since then, the gradually increasing interest of otolaryngologists and neurologists has led to a progressive advance in the knowledge of this labyrinthine disorder with regard to its epidemiologic, pathophysiologic, clinical, and therapeutic aspects. Despite the often effective diagnosis and treatment of most cases of benign paroxysmal positional vertigo, the physiopathologic explanations of the disease are mainly speculative. In this chapter, we describe the epidemiologic, pathophysiologic, clinical, and therapeutic aspects of benign paroxysmal positional vertigo.
良性阵发性位置性眩晕是一种常见的内耳疾病，由半规管内前庭感受器受到机械刺激引起。其特征为位置性眩晕和位置性眼球震颤，二者均由头部相对于重力的位置变化所诱发。由于日常活动受限和跌倒风险增加，该疾病对社会的影响以及对医疗系统造成的直接和间接成本都十分巨大。1921年，罗伯特·巴拉尼首次描述了一名患有良性阵发性位置性眩晕的患者，但1952年迪克和霍尔派克对该综合征的特征及诊断手法进行了详尽描述。自那时起，耳鼻喉科医生和神经科医生的关注度逐渐提高，使得人们对这种内耳疾病在流行病学、病理生理学、临床及治疗等方面的认识不断进步。尽管大多数良性阵发性位置性眩晕病例的诊断和治疗往往有效，但该疾病的病理生理学解释主要仍为推测性的。在本章中，我们将描述良性阵发性位置性眩晕的流行病学、病理生理学、临床及治疗方面。
