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前庭神经炎/神经元炎或周围性前庭病(PVP)的诊断与治疗?悬而未决的问题及可能的答案。

Diagnosis and Treatment of Vestibular Neuritis/Neuronitis or Peripheral Vestibulopathy (PVP)? Open Questions and Possible Answers.

作者信息

Hegemann Stefan C A, Wenzel Angela

机构信息

*Balance-Clinic †Faculty of Medicine, Zurich University ‡Zurich Center for Integrative Human Physiology (ZIHP), Zürich, Switzerland §Universitäts-HNO-Klinik Mannheim, Mannheim, Germany.

出版信息

Otol Neurotol. 2017 Jun;38(5):626-631. doi: 10.1097/MAO.0000000000001396.

Abstract

: The acute vestibular syndrome is a clinically defined entity consisting of vertigo or dizziness that develops acutely over minutes to hours and is accompanied by nausea/vomiting, gait instability, head motion intolerance, and nystagmus, while persisting over a day or more. When it is caused by a peripheral vestibular lesion and is not associated with clinically manifest auditory deficits, it is mostly labeled vestibular neuritis/neuronitis/neuropathy or sometimes peripheral vestibulopathy. Here, we propose hypotheses and discuss current research advances on viral or vascular factors in the pathogenesis, the recurrence, the site of lesion, old and new treatment options, contraindicated measures, the differential diagnosis, and the prognosis of vestibular neuritis/neuronitis/neuropathy or vestibulopathy. Possibly, other structures than the vestibular nerve are also involved in the pathogenetic process and the label peripheral vestibulopathy would be more apt.

摘要

急性前庭综合征是一种临床定义的病症,由在数分钟至数小时内急性发作的眩晕或头晕组成,并伴有恶心/呕吐、步态不稳、头部运动不耐受和眼球震颤,且持续一天或更长时间。当它由外周前庭病变引起且与临床表现出的听觉缺陷无关时,大多被标记为前庭神经炎/神经元炎/神经病变,有时也被称为外周前庭病。在此,我们提出假设并讨论关于病毒或血管因素在发病机制、复发、病变部位、新旧治疗选择、禁忌措施、鉴别诊断以及前庭神经炎/神经元炎/神经病变或前庭病预后方面的当前研究进展。可能除了前庭神经之外,其他结构也参与了发病过程,外周前庭病这一名称可能更合适。

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