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视频头脉冲试验(Vhit)在诊断良性阵发性位置性眩晕(BPPV)中的作用。

The Role of Video Head Impulse Test (Vhit) in Diagnosing Benign Paroxysmal Positional Vertigo (BPPV).

作者信息

Abdulrahim Razna, Bhandary B Satheesh Kumar, Rajeshwary A, Goutham M K, Bhat Vadisha, Saldanha Marina

机构信息

Department of Otorhinolaryngology, NITTE (Deemed University), KS Hegde Medical Academy, Deralakatte, Mangalore, Karnataka India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Aug;74(Suppl 1):506-510. doi: 10.1007/s12070-020-02351-5. Epub 2021 Jan 8.

Abstract

Benign paroxysmal positional vertigo (BPPV) is a common clinical disorder characterized by brief recurrent spells of vertigo often brought about by certain head position changes. General treatment for BPPV is by clinical examination by Dix-Hallpike maneuver, Video head impulse test (VHIT) is a novel test that enhances diagnostic opportunities and enables a clinician to precisely localize the site of vestibular disorders. This interested us to investigate its potential in diagnosis of BPPV.The aim of the present study is to assess the role of Video head impulse test (VHIT) in confirming the clinically diagnosed case of BPPV.All patients above the age of 18 years who were clinically diagnosed with BPPV underwent VHIT and results were correlated with clinical findings. Total 60 patients were studied in the period of 2016-2018.Among the 60 patients clinically diagnosed with BPPV, 41 were males and 19 were females. Majority of patients were in the age group of 51-60 years. Posterior canal is most commonly affected (97%) than anterior and lateral canals in BPPV. In unilateral posterior canal BPPV and bilateral posterior canal BPPV VOR (Vestibulo- ocular reflex) gains was reduced but were not statistically significant. Saccades were present only in 17 cases. There is no relationship between the presence of saccades, the canal involved and the side of the lesion.From the present study we conclude that the currently available equipment for VHIT is not useful in diagnosing BPPV. Also, strongly recommends advanced research on this to record minute changes in VOR gain.

摘要

良性阵发性位置性眩晕(BPPV)是一种常见的临床疾病,其特征是常由某些头部位置变化引发短暂反复发作的眩晕。BPPV的一般治疗方法是通过 Dix-Hallpike 手法进行临床检查,视频头脉冲试验(VHIT)是一种新型检查方法,可增加诊断机会,并使临床医生能够精确确定前庭疾病的部位。这促使我们研究其在BPPV诊断中的潜力。本研究的目的是评估视频头脉冲试验(VHIT)在确诊临床诊断的BPPV病例中的作用。所有18岁以上临床诊断为BPPV的患者均接受了VHIT检查,并将结果与临床发现进行了关联。在2016年至2018年期间共研究了60例患者。在60例临床诊断为BPPV的患者中,男性41例,女性19例。大多数患者年龄在51 - 60岁之间。在BPPV中,后半规管比前半规管和外半规管更常受累(97%)。在单侧后半规管BPPV和双侧后半规管BPPV中,前庭眼反射(VOR)增益降低,但无统计学意义。仅17例出现扫视。扫视的存在、受累半规管和病变侧之间没有关系。从本研究中我们得出结论,目前可用的VHIT设备在诊断BPPV方面无用。此外,强烈建议对此进行深入研究以记录VOR增益的微小变化。

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