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询问在床上翻身时的头晕情况可预测良性阵发性位置性眩晕的检查结果。

Asking about dizziness when turning in bed predicts examination findings for benign paroxysmal positional vertigo.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.

Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.

出版信息

J Vestib Res. 2018;28(3-4):339-347. doi: 10.3233/VES-180637.

Abstract

BACKGROUND

Benign paroxysmal positional vertigo (BPPV) is the single most common cause of vestibular vertigo and is characterised by short episodes of rotational vertigo precipitated by changes in head positions like lying down or turning in bed.

OBJECTIVE

This study aims to assess useful questions when suspecting benign paroxysmal positional vertigo (BPPV) caused dizziness as well as identifying if a single question can be useful in identify or distinguish patients with BPPV from other dizziness aetiology.

METHOD

A total of 149 patients admitted due to dizziness were included. Patients answered a questionnaire and were investigated for BPPV with diagnostic manoeuvres.

RESULT

Two of the 15 questions were of diagnostic importance. Dizziness when laying down or turning in bed, increased likelihood of BPPV by an odds ratio (95% confidence interval) of 60 (7.47-481.70). Continuous dizziness duration as opposed to lasting seconds decreased likelihood of BPPV with an odds ratio of 0.06 (0.01-0.27).

CONCLUSION

Vertiginous attacks by turning or laying down in bed together with dizziness <1 minute, are important questions and strongly related to BPPV. Such questions are important when taking a medical history and may help to early identify BPPV, also for non-medical staff, as well as reduce the need of further investigations.

摘要

背景

良性阵发性位置性眩晕(BPPV)是前庭性眩晕的单一最常见病因,其特征是由头位变化引起的短暂旋转性眩晕发作,如躺下或在床上翻身。

目的

本研究旨在评估怀疑良性阵发性位置性眩晕(BPPV)引起的头晕时有用的问题,并确定单个问题是否有助于识别或区分 BPPV 患者与其他头晕病因。

方法

共纳入 149 例因头晕就诊的患者。患者回答了一份问卷,并接受了诊断性手法检查以明确是否存在 BPPV。

结果

15 个问题中有 2 个具有诊断意义。当躺下或在床上翻身时出现头晕,发生 BPPV 的可能性增加 60 倍(95%置信区间为 7.47-481.70)。持续时间超过 1 分钟的持续性头晕,发生 BPPV 的可能性降低 60 倍(95%置信区间为 7.47-481.70)。

结论

与 BPPV 强烈相关的是,在床上翻身或躺下时出现眩晕发作以及头晕持续时间<1 分钟。这些问题在采集病史时很重要,有助于早期识别 BPPV,即使是非医务人员也能识别,同时减少进一步检查的需求。

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