Zhao D, Jiang Z G
Department of Otology, First Hospital of Qinhuangdao, Qinhuangdao, 066000, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Aug 5;32(15):1134-1138. doi: 10.13201/j.issn.1001-1781.2018.15.003.
The features and parameters of the relief of nystagmus during the restoration of benign paroxysmal positional vertigo(PC-BPPV) in the posterior semicircular canal were observed to explore its clinical significance and mechanism. Sixty-eight patients with PC-BPPV were treated with the Epley method. According to the subject' nystagmus relief was present or not, they were divided into two groups: group A showed relief of nystagmus during the restoration process, and group B showed no relief of nystagmus during the restoration. The effect of restoration between group A and group B was compared, and the parameters of nystagmus between the detached nystagmus and the Hallpike position in group A patients with detachable nystagmus were compared. Of the 68 patients with PC-BPPV, 33(48.5%) experienced detachment of nystagmus in the same direction as the initial nystagmus(Group A) during the restoration; 35(51.5%) patients had no nystagmus during the restoration(Group B). After the instrument was reset for 2 h, Dix-Hallpike test was performed again. The success rate of reset was 100% in group A,and that was 57% in group B(20 cases were successfully repositioned, and 15 cases showed typical nystagmus). The success rate of reset was statistically different between groups A and B(<0.01). After one week of resetting, the telephone follow-up was carried out. The recovery rate of group A and group B were 93% and 74% separately.The recovery rates between group A and B were statistically different(<0.05). In group A, the nystagmus latency at Hallpike was(2.63±2.17) s, and the duration was(17.27±5.94) s. The rate of nystagmus in the upper leaping eye was(16.19±9.54)°/s. The latency of liberation was(2.30±1.41) s and the duration was(11.84±5.98) s. In seconds, the slow phase phasic velocity of the nystagmus was(7.80±4.57)°/s; there was no statistical difference in latency between the detached nystagmus and the Hallpike nystagmus(>0.05), while there was a statistically significant difference between the duration and the nystagmus intensity(<0.01).For PC-BPPV restoration, the presence or absence of nystagmus can be used as a reference to judge whether the restoration succeed or not.The latency of nystagmus at the Hallpike position may be related to the stalactite precipitation rate. The duration and the slow phase angle velocity of the upper hop eye may be related to the otolith quantity.
观察后半规管良性阵发性位置性眩晕（PC-BPPV）复位过程中眼震缓解的特征及参数，以探讨其临床意义及机制。68例PC-BPPV患者采用Epley法治疗。根据患者眼震是否缓解分为两组：A组复位过程中眼震缓解，B组复位过程中眼震未缓解。比较A、B两组复位效果，并比较A组可分离性眼震患者分离性眼震与Hallpike位眼震的参数。68例PC-BPPV患者中，33例（48.5%）复位过程中出现与初始眼震同向的眼震分离（A组）；35例（51.5%）患者复位过程中无眼震（B组）。仪器复位2小时后再次进行Dix-Hallpike试验。A组复位成功率为100%，B组为57%（20例成功重新定位，15例出现典型眼震）。A、B两组复位成功率差异有统计学意义（<0.01）。复位一周后进行电话随访。A、B两组的恢复率分别为93%和74%。A、B两组恢复率差异有统计学意义（<0.05）。A组Hallpike位眼震潜伏期为（2.63±2.17）s，持续时间为（17.27±5.94）s。上跳眼眼震速率为（16.19±9.54）°/s。分离潜伏期为（2.30±1.41）s，持续时间为（11.84±5.98）s。以秒为单位，眼震慢相相速度为（7.80±4.57）°/s；分离性眼震与Hallpike眼震潜伏期差异无统计学意义（>0.05），而持续时间和眼震强度差异有统计学意义（<0.01）。对于PC-BPPV复位，眼震是否出现可作为判断复位是否成功的参考。Hallpike位眼震潜伏期可能与耳石沉积率有关。上跳眼的持续时间和慢相角速度可能与耳石量有关。
