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[一种前庭康复技术——前庭习服训练的原理与阐述]

[Principles and elaboration of a vestibular rehabilitation technic, vestibular habituation training].

作者信息

Norré M E, de Weerdt W

出版信息

Ann Otolaryngol Chir Cervicofac. 1979 Apr-May;96(4-5):217-27.

PMID:314768
Abstract

In the scope of the treatment of some vertiginous patients, the vestibular habituation training has to be considered as a valuable technique, superior to the merely medical treatment by drugs. Bsed on the fundamental principles of the vestibular physiopathology, its aim is to favour the compensatory and adaptive functions of the vestibular regulation centres in case of a peripheral dysfunction, either a unilateral hypofunction or some type of paroxysmal positional vertigo. The repeating of the provoking manoeuvres results in a habituation effect, so that the centres accept this abnormal stimulation pattern and are able to transform it in an equilibrated elaboration of the reflexes. In this way, every dizzy sensation can be abolished. So each case presenting provoked dizziness, either on the base of unilateral vestibular hypofunction, or as a typical paroxysmal positional vertigo, can be treated in this way. The patients are selected by anamnesis and thorough functional evaluation with search for positional nystagmus, caloric and rotation tests, recorded by E.N.G. Afterwards movements and positions provoking dizziness are tested in a practical way, leading to a selection of movements which are used in order to compose the treatment schedule. This test battery permits also to realize a close and precise follow-up of these patients, besides the classical clinical and E.N.G. evaluations. A preliminary report of 62 cases is presented. We found a positive result in more than 2/3 of the cases after 2 months. This technique being subject of further intensive investigations in our department, we make reservations as to future changes in the technique and procedures presented in this study. We would like to emphasize this treatment has to be integrated in a global clinical approach to the dizzy patient.

摘要

在某些眩晕患者的治疗范围内,前庭习服训练必须被视为一种有价值的技术,优于单纯的药物治疗。基于前庭生理病理学的基本原理,其目的是在出现外周功能障碍时,即单侧功能减退或某种类型的阵发性位置性眩晕时,促进前庭调节中枢的代偿和适应功能。诱发动作的重复会产生习服效应,使中枢接受这种异常刺激模式,并能够将其转化为平衡的反射活动。通过这种方式,每一种头晕感觉都可以消除。因此,每一例因单侧前庭功能减退或典型的阵发性位置性眩晕而引发头晕的病例都可以用这种方法治疗。通过问诊和全面的功能评估来选择患者,包括寻找位置性眼球震颤、冷热试验和旋转试验,并通过眼震电图记录下来。之后,以实际方式测试诱发头晕的动作和体位,从而选择用于制定治疗方案的动作。除了经典的临床和眼震电图评估外,这套测试方法还可以对这些患者进行密切而精确的随访。本文给出了62例患者的初步报告。我们发现,2个月后超过2/3的病例有阳性结果。由于这项技术在我们科室仍在接受进一步深入研究,我们对本研究中所呈现的技术和程序未来可能的变化持保留态度。我们想强调的是,这种治疗必须纳入对头晕患者的整体临床治疗方案中。

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