Makarov S A, Guseva A L, Dyukova G M, Golubev V L, Danilov A B
I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.
N.I. Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Moscow, Russia.
Vestn Otorinolaringol. 2020;85(5):51-56. doi: 10.17116/otorino20208505151.
To assess the clinical and psychological features in patients with incident and recurrent posterior canal BPPV.
The study included 47 patients (mean age 49.1±10.9 years; 12.8% of men and 87.2% of women) with idiopathic BPPV, posterior canal. According to the anamnesis, the patients were divided into two groups: 27 (57.4%) patients with incident BPPV (iBPPV) and 20 (42.6%) patients with recurrent BPPV (rBPPV). All patients were treated with repositioning Epley and/or Semont maneuvers until resolution of canalolithiasis. After that, clinical and psychological testing was immediately carried out, including short version of Vertigo Symptom Scale (VSS), Dizziness Handicap Inventory (DHI), Visual analogue scale (VAS) for fear of vertigo spells, Depersonalization-Derealization Inventory (DDI), Social Readjustment Rating Scale (SRRS) of Holmes and Rahe, Anxiety Sensitivity Index (ASI), Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire (PHQ).
Patients with rBPPV compared with iBPPV had more severe symptoms of dizziness according to DHI (=0.02) due to a functional and emotional subscales, as well as a more pronounced feeling of fear according to VAS (=0.01). The data obtained on the remaining scales and questionnaires did not show statistically significant differences between the groups. The revealed results may indicate a greater predisposition of patients with rBPPV to the development of a special kind of mental disorders - functional dizziness or persistent postural-perceptual dizziness, which requires additional study and development of preventive measures.
评估初发性和复发性后半规管良性阵发性位置性眩晕(BPPV)患者的临床和心理特征。
本研究纳入47例特发性后半规管BPPV患者(平均年龄49.1±10.9岁;男性占12.8%,女性占87.2%)。根据病史,将患者分为两组:27例(57.4%)初发性BPPV(iBPPV)患者和20例(42.6%)复发性BPPV(rBPPV)患者。所有患者均接受复位Epley和/或Semont手法治疗,直至嵴顶结石症消失。之后,立即进行临床和心理测试,包括眩晕症状量表简版(VSS)、头晕残障量表(DHI)、眩晕发作恐惧视觉模拟量表(VAS)、人格解体-现实解体量表(DDI)、霍姆斯和拉赫社会再适应评定量表(SRRS)、焦虑敏感性指数(ASI)、广泛性焦虑障碍量表(GAD-7)和患者健康问卷(PHQ)。
根据DHI(P=0.02),rBPPV患者与iBPPV患者相比,由于功能和情感分量表,头晕症状更严重,根据VAS(P=0.01),恐惧感觉更明显。在其余量表和问卷上获得的数据显示两组之间无统计学显著差异。所揭示的结果可能表明rBPPV患者更容易发生一种特殊类型的精神障碍——功能性头晕或持续性姿势-感知性头晕,这需要进一步研究并制定预防措施。