Zhang Y M, Yang Z D, Yu Y F
Department of Otorhinolaryngology, the First Affiliated Hospital of Soochow University,Suzhou,215006, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Sep 20;30(18):1435-1437;1443. doi: 10.13201/j.issn.1001-1781.2016.18.003.
To explore the role of video nystagmography in the diagnosis and treatment of multiple benign paroxysmal positional vertigo. Eleven patients of 313 patients with benign paroxysmal positional vertigo had been diagnosed as multiple benign paroxysmal positional vertigo.They were post and horizontal semicircular canal ipsilaterally, bilateral post semicircular canal, superior and horizontal semicircular canal ipsilaterally, and bilateral superior semicircular canal benign paroxysmal positional vertigo.The patients were performed Dix-Hallpike test and Roll test under VNG, combined with track record by video nystagmography to confirm the affected sites. Six cases were post and horizontal semicircular canal benign paroxysmal positional vertigo ipsilaterally. Three cases were bilateral posterior semicircular canal benign paroxysmal positional vertigo, one case of superior semicircular canal and horizontal semicircular canal benign paroxysmal positional vertigo ipsilaterally, and one case of bilateral superior semicircular canal benign paroxysmal positional vertigo. The symptom of patients got relief after repositioning sequentially. We repositioned the affected canal with strong nystagmus and vertigo at the first time. Multiple benign paroxysmal positional vertigo was rare and easily misdiagnosed because of complex nystagmus. We can confirm the affected canal and intensity by video nystagmography and get good prognosis after repositioning sequentially.
探讨视频眼震电图在多发性良性阵发性位置性眩晕诊断及治疗中的作用。在313例良性阵发性位置性眩晕患者中,有11例被诊断为多发性良性阵发性位置性眩晕。分别为同侧后半规管及水平半规管、双侧后半规管、同侧上半规管及水平半规管、双侧上半规管良性阵发性位置性眩晕。对患者在视频眼震电图(VNG)下进行Dix-Hallpike试验和Roll试验,并结合视频眼震电图记录以确定受累部位。其中6例为同侧后半规管及水平半规管良性阵发性位置性眩晕。3例为双侧后半规管良性阵发性位置性眩晕,1例为同侧上半规管及水平半规管良性阵发性位置性眩晕,1例为双侧上半规管良性阵发性位置性眩晕。患者经依次复位后症状缓解。首次对出现强烈眼震及眩晕的受累半规管进行复位。多发性良性阵发性位置性眩晕较为罕见,因其眼震复杂,容易误诊。通过视频眼震电图可确定受累半规管及强度,经依次复位后可获得良好预后。