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开发用于识别急性头晕中前庭神经炎的诊断算法:流行病学、发病机制概述及基于证据的诊断方法指南

Developing a Diagnostic Algorithm for Identifying Vestibular Neuronitis in Acute Dizziness: An Overview of Epidemiology, Pathogenesis, and Evidence-Based Guidelines for Diagnostic Approaches.

作者信息

Vlastarakos Petros V, Sideris Giorgos, Vasileiou Eleni, Michailidou Efterpi, Papadimitriou Nikolaos, Palantzas Dimitrios, Melissourgou Konstantina, Panagoulis Evangelos, Gogoulos Panagiotis P, Nikolopoulos Thomas

机构信息

2nd ENT Department, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.

Otolaryngology - Head and Neck Surgery, Inselspital, University Hospital of Bern, Bern, CHE.

出版信息

Cureus. 2025 Jan 28;17(1):e78126. doi: 10.7759/cureus.78126. eCollection 2025 Jan.

Abstract

Vestibular neuronitis (VN) is a prevalent peripheral vestibular disorder presenting with sudden unilateral vestibular loss, leading to acute vertigo without associated cochlear or neurological symptoms. Diagnosis remains challenging due to symptom overlap with other vestibular and central disorders. This study reviews the epidemiology, pathogenesis, and diagnostic approaches for VN to propose a streamlined, evidence-based diagnostic algorithm. A comprehensive literature review was conducted, analyzing 114 studies, including randomized controlled trials, systematic reviews, and clinical guidelines. Emphasis is placed on the clinical history and bedside examinations, supported by ancillary tests to confirm the diagnosis and differentiate VN from central and other peripheral causes of vertigo. The proposed algorithm aims to enhance diagnostic precision and support clinical decision-making.

摘要

前庭神经炎(VN)是一种常见的外周前庭疾病,表现为突然单侧前庭功能丧失,导致急性眩晕,且无相关的耳蜗或神经症状。由于与其他前庭和中枢性疾病症状重叠,诊断仍然具有挑战性。本研究回顾了VN的流行病学、发病机制和诊断方法,以提出一种简化的、基于证据的诊断算法。进行了全面的文献综述,分析了114项研究,包括随机对照试验、系统评价和临床指南。重点在于临床病史和床边检查,并辅以辅助检查以确诊并将VN与中枢性及其他外周性眩晕原因相鉴别。所提出的算法旨在提高诊断准确性并支持临床决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d39/11866987/55e6b4ea7988/cureus-0017-00000078126-i01.jpg

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