Jeong Seong-Hae
Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea.
Front Neurol. 2020 Oct 16;11:589605. doi: 10.3389/fneur.2020.589605. eCollection 2020.
Many investigations have found common occurrences of benign paroxysmal positional vertigo (BPPV) in women, and clinical experience has shown that BPPV can develop due to increased hormonal fluctuations, especially during menopause. Therefore, knowledge about neurochemicals and their involvement with BPPV is imperative for the management of neurological issues in women. This review will discuss appropriate gender-based considerations of BPPV based on experimental and clinical evidence. The studies describe 2 lines of evidence regarding the association of perimenopause in women and the development of BPPV: (1) experimental evidence: the existence of estrogen receptors in the inner ear, otoconial malformations in osteopenic/osteoporotic rats, changes in otoconin 90 caused by hormone replacement therapy, and impaired calcium absorption following estrogen deprivation corrected by estrogen replacement therapy and (2) clinical evidence: epidemiological aspects, osteoporosis and estrogen deficiency. Future studies are necessary to validate the effects of hormonal replacement therapy and phytoestrogen in women with recurrent BPPV.
许多调查发现女性中良性阵发性位置性眩晕（BPPV）很常见，临床经验表明，BPPV可因激素波动增加而发生，尤其是在更年期期间。因此，了解神经化学物质及其与BPPV的关系对于管理女性神经问题至关重要。本综述将根据实验和临床证据讨论基于性别的BPPV相关适宜考量。这些研究描述了关于女性围绝经期与BPPV发生之间关联的两条证据线：（1）实验证据：内耳中雌激素受体的存在、骨质减少/骨质疏松大鼠的耳石畸形、激素替代疗法引起的耳石素90变化，以及雌激素替代疗法纠正雌激素缺乏后钙吸收受损；（2）临床证据：流行病学方面、骨质疏松症和雌激素缺乏。未来有必要开展研究以验证激素替代疗法和植物雌激素对复发性BPPV女性的疗效。
