Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, 100049, People's Republic of China.
Department of Neurology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121001, People's Republic of China.
J Neurol. 2019 Jul;266(7):1674-1684. doi: 10.1007/s00415-019-09312-1. Epub 2019 Apr 8.
To investigate the diagnosis strategy of anterior canal-benign paroxysmal positional vertigo (AC-BPPV) and the therapeutic effects of the Yacovino maneuver.
The clinical data of 40 AC-BPPV patients were collected. The nystagmus characteristics induced by the Dix-Hallpike (D-H) and straight head-hanging (SHH) tests, the diagnostic methods used, and the effectiveness of the Yacovino maneuver for the treatment of AC-BPPV were all retrospectively analyzed.
Among the 40 cases analyzed, 19 patients had simple AC-BPPV, 11 patients had AC-posterior canal BPPV, and 10 patients had AC-horizontal canal BPPV. D-H and SHH tests showed down-beating nystagmus in 26 and 33 patients, respectively, and showed down-beating and torsional nystagmus in 14 and 7 patients, respectively. AC-BPPV was diagnosed in 15 patients based on the presence of typical BPPV in other canals, in 9 patients based on typical disease history and the results of position tests, in 6 patients based on effectiveness of the treatment with the Yacovino maneuver, in 4 patients based on the treatment effectiveness and the presence of typical BPPV in other canals, in 3 patients based on the treatment effectiveness and the follow-up outcome, in 2 patients based on the typical BPPV in other canals and occurrence of canal conversion, and in 1 patient based on the treatment effectiveness and occurrence of canal conversion. Thirteen patients with canalolithiasis and four patients with cupulolithiasis were cured after the initial Yacovino maneuver treatment. Twenty-one patients with canalolithiasis and seven patients with cupulolithiasis were cured following 1 week of treatment.
The effectiveness of the Yacovino maneuver, the follow-up outcome, the presence of typical BPPV in other canals, and the occurrence of canal conversions contribute to AC-BPPV diagnosis. The Yacovino maneuver was found to be more effective in AC-BPPV patients with canalolithiasis than in those with cupulolithiasis.
探讨前半规管良性阵发性位置性眩晕（AC-BPPV）的诊断策略及 Yacovino 手法的治疗效果。
回顾性分析 40 例 AC-BPPV 患者的临床资料，分析 D-H 试验和 SHH 试验诱发的眼震特征、采用的诊断方法及 Yacovino 手法治疗 AC-BPPV 的疗效。
40 例患者中单纯 AC-BPPV 19 例，AC-后半规管 BPPV 11 例，AC-水平半规管 BPPV 10 例。D-H 试验和 SHH 试验分别显示 26 例和 33 例患者为下跳性眼震，14 例和 7 例患者显示下跳性和扭转性眼震。根据其他半规管典型 BPPV 存在诊断为 AC-BPPV 的患者 15 例，根据典型病史和位置试验结果诊断为 AC-BPPV 的患者 9 例，根据 Yacovino 手法治疗效果诊断为 AC-BPPV 的患者 6 例，根据治疗效果和其他半规管存在典型 BPPV 诊断为 AC-BPPV 的患者 4 例，根据治疗效果和随访结果诊断为 AC-BPPV 的患者 3 例，根据其他半规管典型 BPPV 存在和管石症转化诊断为 AC-BPPV 的患者 2 例，根据治疗效果和管石症转化诊断为 AC-BPPV 的患者 1 例。初次 Yacovino 手法治疗后，13 例耳石症和 4 例嵴帽结石症患者痊愈。1 周后，21 例耳石症和 7 例嵴帽结石症患者痊愈。
Yacovino 手法的疗效、随访结果、其他半规管存在典型 BPPV 及管石症转化有助于 AC-BPPV 的诊断。与嵴帽结石症相比，Yacovino 手法治疗耳石症的效果更好。
