良性阵发性位置性眩晕及其诊断、治疗与鉴别诊断

Benign positional vertigo, its diagnosis, treatment and mimics.

作者信息

Argaet E C, Bradshaw A P, Welgampola M S

机构信息

Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia.

The Balance Clinic and Laboratory, 155 Missenden Rd Camperdown, Sydney, Australia.

出版信息

Clin Neurophysiol Pract. 2019 Apr 6;4:97-111. doi: 10.1016/j.cnp.2019.03.001. eCollection 2019.

DOI:10.1016/j.cnp.2019.03.001

PMID:31193795

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6542326/

Abstract

The diagnosis of benign positional vertigo (BPV) relies on a history of episodic positional vertigo and a distinctive pattern of nystagmus during provocative positional testing. The direction of the induced nystagmus is specific to the affected canal and the velocity profile reflects the underlying mechanism of canalithiasis (free-floating otoconia within the canal duct) or cupulolithiasis (otoconia adherent to the cupula). We review current theories on the pathophysiology of BPV, the clinical history and examination underlying its diagnosis, and recommended repositioning manoeuvres for each of the BPV subtypes. Disorders other than BPV which may present with a similar history and/or positional nystagmus are discussed.

摘要

良性阵发性位置性眩晕（BPV）的诊断依赖于发作性位置性眩晕病史以及激发性位置试验期间特征性的眼球震颤模式。诱发眼球震颤的方向特定于受影响的半规管，其速度特征反映了管结石症（半规管内自由漂浮的耳石）或嵴帽结石症（耳石附着于嵴帽）的潜在机制。我们回顾了当前关于BPV病理生理学的理论、其诊断所依据的临床病史和检查，以及针对每种BPV亚型推荐的复位手法。还讨论了可能表现出类似病史和/或位置性眼球震颤的BPV以外的疾病。