Parnes L S, Price-Jones R G
Department of Otolaryngology, University of Western Ontario, London, Canada.
Ann Otol Rhinol Laryngol. 1993 May;102(5):325-31. doi: 10.1177/000348949310200501.
Benign paroxysmal positional vertigo is a common, most often self-limited, vestibular end organ disorder that in some cases may be quite disabling. Recent evidence suggests that some, if not most, cases result from free-floating posterior semicircular canal endolymph particles. We postulate that the particle repositioning maneuver displaces these particles from the posterior canal through the common crus into the utricle, where they no longer induce pathologic responses. Our report focuses on 38 consecutive patients treated with this simple bedside technique during a 10-month period. On follow-up, 26 patients (68.4%) were free of disease, 4 (10.5%) were significantly improved, 4(10.5%) remained unchanged, and 4(10.5%) were lost to follow-up. Of the 4 patients who remained unchanged, 2 underwent successful posterior semicircular canal occlusions. The direction of the nystagmus during the second stage of the maneuver appears important in predicting the efficacy, with reversal of nystagmus denoting a poor response. These findings provide additional insight into the pathophysiology of this disorder.
良性阵发性位置性眩晕是一种常见的、通常为自限性的前庭终末器官疾病，在某些情况下可能会导致严重功能障碍。最近的证据表明，部分（即便不是大多数）病例是由后半规管内淋巴液颗粒漂浮所致。我们推测，颗粒复位手法可将这些颗粒从后管经总脚移入椭圆囊，在椭圆囊中它们不再诱发病理反应。我们的报告聚焦于在10个月期间连续接受这一简单床边技术治疗的38例患者。随访时，26例患者（68.4%）疾病痊愈，4例（10.5%）显著改善，4例（10.5%）病情未变，4例（10.5%）失访。在病情未变的4例患者中，2例成功接受了后半规管阻塞术。手法第二阶段眼震的方向在预测疗效方面似乎很重要，眼震方向反转表明反应不佳。这些发现为该疾病的病理生理学提供了更多见解。
