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基于虚拟现实的 Dix-Hallpike 变位试验性眼震分析。

Analysis of Dix-Hallpike maneuver induced nystagmus based on virtual simulation.

机构信息

Neurology Department, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University/Third Affiliated Hospital of Shanghai University/Wenzhou People's Hospital, Wenzhou, Zhejiang, China.

出版信息

Acta Otolaryngol. 2021 May;141(5):433-439. doi: 10.1080/00016489.2021.1876247. Epub 2021 Feb 9.

Abstract

BACKGROUND

How to interpret the various forms of nystagmus induced by the Dix-Hallpike maneuver has been the hotspot and difficulty of research.

OBJECTIVES

Analysis of the types of nystagmus induced by Dix-Hallpike maneuver, and establish a diagnosis strategy based on dynamic nystagmus observation.

MATERIALS AND METHODS

We observed the otolithic movements at different locations during the Dix-Hallpike maneuver through physical virtual simulation experiments and inferred the nystagmus performance, so as to establish the nystagmus interpretation rules for the repeated Dix-Hallpike maneuver.

RESULTS

There are six types of nystagmus induced by the Dix-Hallpike maneuver. Nystagmus induced by the unilateral Dix-Hallpike maneuver does not accurately locate the otolith. The typical nystagmus that is consistent before and after the repetition of the Dix-Hallpike maneuver is the outward and upbeat nystagmus, considering the ipsilateral posterior semicircular canal BPPV.

CONCLUSION

The atypical nystagmus often turns negative when the Dix-Hallpike maneuver is repeated. If the repeat test is positive and consistent with the results of the first diagnostic test, the otolith can be accurately located.

摘要

背景

如何解读 Dix-Hallpike 手法诱发的各种类型的眼震一直是研究的热点和难点。

目的

分析 Dix-Hallpike 手法诱发的眼震类型,并基于动态眼震观察建立诊断策略。

材料与方法

通过物理虚拟仿真实验观察 Dix-Hallpike 手法过程中不同部位的耳石运动,推断眼震表现,从而建立反复 Dix-Hallpike 手法的眼震解读规则。

结果

Dix-Hallpike 手法可诱发六种类型的眼震。单侧 Dix-Hallpike 手法诱发的眼震不能准确定位耳石。在 Dix-Hallpike 手法重复前后表现一致的典型眼震是向外上的眼震,提示同侧后半规管 BPPV。

结论

反复 Dix-Hallpike 手法时,不典型眼震常转为阴性。如果重复试验阳性且与首次诊断性试验结果一致,则可准确定位耳石。

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