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创伤后良性阵发性位置性眩晕;创伤后头晕的一个诊断不足的原因

[Post-traumatic benign paroxysmal positional vertigo; an underdiagnosed cause of dizziness following trauma].

作者信息

Huang W, Hoogervorst Erwin L J, Kupperman David, Wessels Peter H

机构信息

St. Antonius Ziekenhuis, afd. Neurologie, Utrecht.

St. Antonius Ziekenhuis, afd. KNO, Utrecht.

出版信息

Ned Tijdschr Geneeskd. 2019 Jul 18;163:D3757.

Abstract

Dizziness is a frequently reported symptom following head trauma. Although often ascribed to concussion, post-traumatic benign paroxysmal positional vertigo (BPPV) must be included in the differential diagnosis. In this article, three patients who attended a neurology outpatient clinic with persistent dizziness following head trauma were ultimately diagnosed with post-traumatic BPPV. Dizziness lessened substantially once a canalith repositional manoeuvre was performed. Patients with post-traumatic BPPV are generally younger, report more severe symptoms and have a higher rate of relapse. Diagnosing post-traumatic BPPV can be challenging due to the presence of more urgent injuries in the initial phase and the habitual attribution of symptoms to concussion. A timely diagnosis is crucial, however, since treatment is easy to perform, non-invasive and effective.

摘要

头晕是头部创伤后经常报告的症状。虽然通常归因于脑震荡,但创伤后良性阵发性位置性眩晕(BPPV)必须纳入鉴别诊断。在本文中,三名因头部创伤后持续头晕而到神经科门诊就诊的患者最终被诊断为创伤后BPPV。一旦进行了耳石复位手法,头晕症状就会大幅减轻。创伤后BPPV患者通常更年轻,症状更严重,复发率更高。由于初始阶段存在更紧急的损伤以及症状习惯性地归因于脑震荡,创伤后BPPV的诊断可能具有挑战性。然而,及时诊断至关重要,因为治疗操作简便、无创且有效。

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