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坐位-仰卧位定位性眼震对良性阵发性位置性眩晕诊断的意义

[Significance of the seated supine positioning nystagmus for the diagnosis of benign paroxysmal positional vertigo].

作者信息

Liang X H, Sun P Y, Peng X, Liu J M, Chen Z, Shan X Z

机构信息

College of Clinical Medicine,General Hospital of Chinese People's Armed Police Forces,Anhui Medical University,Hefei,230032,China.

Department of Otorhinolaryngology Head and Neck Surgery,Institute of Dizziness,General Hospital of Chinese People's Armed Police Forces.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 May 5;31(9):703-707. doi: 10.13201/j.issn.1001-1781.2017.09.014.

Abstract

To observe and assess the significance of seated supine positioning nystagmus (SSPN) in the diagnosis of benign paroxysmal positional vertigo(BPPV).Two hundreds patients who were diagnosed BPPV were tested with the seated supine positioning test(SSPT) to observe SSPN,then were tested Supine roll test(SRT) and Dix-Hallpike test(DHT). According to the result of SRT and DHT,patients were divided into different groups. The positive rate and feature of SSPN in different types of BPPV was analyzed.Among the 200 patients,116 cases(58.0%) of them showed SSPN. Among the 116 cases who were divided to the posterior semicircular canal BPPV(PSC-BPPV) group,72 cases of them showed SSPN. Horizontal semicircular canal BPPV(HSC-BPPV) group were 60 cases,44 cases showed SSPN. Anterior semicircular canal BPPV(ASC-BPPV) group were 4 cases and none of them showed SSPN. The direction of SSPN was a combination of torsional nystagmus with the upper pole of the eyes beating toward the affected side combined with vertical nystagmus beating upward (toward the forehead) typically in the PSC-BPPV group. Canalolithiasis of HSC were 41 cases,and 28 cases showed SSPN,and SSPN was contralesional in 22 cases(78.6%) and ipsilesional in 6 cases. Cupulolithiasis of HSC were 19 cases and 16 cases showed SSPN,and SSPN was ipsilesional in 16 cases.Significance of the seated supine positioning nystagmus in different types of BPPV is different.

摘要

观察并评估坐位仰卧位眼震(SSPN)在良性阵发性位置性眩晕(BPPV)诊断中的意义。对200例诊断为BPPV的患者进行坐位仰卧位试验(SSPT)以观察SSPN,然后进行仰卧翻身试验(SRT)和Dix-Hallpike试验(DHT)。根据SRT和DHT的结果,将患者分为不同组。分析不同类型BPPV中SSPN的阳性率及特征。200例患者中,116例(58.0%)出现SSPN。在分为后半规管BPPV(PSC-BPPV)组的116例患者中,72例出现SSPN。水平半规管BPPV(HSC-BPPV)组60例,44例出现SSPN。前半规管BPPV(ASC-BPPV)组4例,均未出现SSPN。在PSC-BPPV组中,SSPN的方向通常是扭转性眼震合并眼球上极向患侧跳动以及垂直性眼震向上(朝向额头)跳动。HSC管结石症41例,28例出现SSPN,其中22例(78.6%)SSPN为对侧性,6例为同侧性。HSC嵴顶结石症19例,16例出现SSPN,均为同侧性。坐位仰卧位眼震在不同类型BPPV中的意义不同。

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