DHM阴性的非典型PSC-BPPV诊断策略探讨

doi:10.6040/j.issn.1673-3770.0.2016.055

山东大学耳鼻喉眼学报 ›› 2017, Vol. 31 ›› Issue (1): 88-90.doi: 10.6040/j.issn.1673-3770.0.2016.055

DHM阴性的非典型PSC-BPPV诊断策略探讨

刘学升,李筱瑜,邓玮

青岛市市立医院神经内科, 山东青岛 266011

收稿日期:2016-02-15 出版日期:2017-02-16 发布日期:2017-02-16
通讯作者: 邓玮. E-mail:deng64-wei128@163.com

Exploration of diagnostic strategy for atypical PSC-BPPV with negative DHM.

Department of Neurology, Qingdao Municipal Hospital, Qingdao 266011, Shandong, China

Received:2016-02-15 Online:2017-02-16 Published:2017-02-16

摘要/Abstract

摘要： 目的探讨Dix-Hallpike诱发试验(DHM)阴性的非典型后半规管良性阵发性位置性眩晕(PSC-BPPV)的诊断策略。方法回顾性分析DHM阴性的非典型PSC-BPPV的诊断过程,对55例存在Dix-Hallpike诱发试验阴性的非典型PSC-BPPV患者,进行双侧Epley复位治疗及疗效观察,对比按照阳性DHM诊断和根据Epley复位治疗结合疗效进行诊断间的早期确诊率。结果双侧进行DHM和双侧Epley复位治疗法治疗效果的确诊率分别为35.6%、100.0%。结论与按照阳性DHM诊断PSC-BPPV对比,Epley复位治疗结合疗效观察能够显著提高PSC-BPPV的早期确诊率,且能避免漏诊双侧PSC-BPPV。

关键词: 良性阵发性位置性眩晕, Dix-Hallpike诱发试验, 确诊率

Abstract: Objective To explore the diagnostic strategy of atypical posterior semicanal benign paroxysmal positional vertigo(PSC-BPPV)with negative Dix-Hallpike maneuver(DHM). Methods The diagnostic course of 55 cases of atypical PSC-BPPV with negative DHM was retrospectively reviewed. Epley maneuver was performed bilaterally and its effectiveness was observed. The early confirmed diagnostic rates according to positive DHM and Epley maneuver were compared. Results The confirmed diagnostic rate according to positive DHM and bilateral Epley maneuver were 35.6% and 100.0%, respectively. Conclusion Compared with positive DHM, bilateral Epley maneuver is more effective in the early diagnosis of PSC-BPPV, which can also avoid missed diagnosis of bilateral PSC-BPPV.

Key words: Confirmed diagnostic rate, Dix-Hallpike maneuver, Benign paroxysmal positional vertigo

中图分类号:

R764.4

刘学升,李筱瑜,邓玮. DHM阴性的非典型PSC-BPPV诊断策略探讨[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 88-90.

参考文献

[1] 吴子明. 美国耳鼻咽喉头颈外科学会BPPV治疗指南介绍[J]. 听力学及语言疾病杂志, 2009, 17(5):502. WU Ziming. The American society of otolaryngology head and neck surgery BPPV guidelines are introduced[J]. J Audiol Speech Pathol, 2009, 17(5):502.
[2] Bhattacharyya N, Baugh RF, Orvidas L, et al. Clinical practice guideline: Benign paroxysmal positional vertigo[J]. Otolaryngol Head Neck Surg, 2008, 139(5 Suppl 4):47-81.
[3] Fife TD, Iverson DJ, Lempert T, et al. Practice parameter: therapies for benign paroxysmal positional vertigo(an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology[J]. Neurology, 2008, 70(22):2067-2074.
[4] Hotson JR, Baloh RW. Acute vestibular syndrome[J]. N Engl J Med, 1998, 339(10):680-685.
[5] Haynes DS, Resser JR, Labadie RF, et al. Treatment of benign positional vertigo using the Semont maneuver: efficacy in patients presenting without nystagmus[J]. Laryngoscope, 2002, 112(5):796-801.
[6] 蒋子栋. 良性阵发性位置性眩晕诊治中相关问题的探讨[J]. 听力学及言语疾病杂志, 2013, 21(2):106-108. JIANG Zidong. BPPV related issues of the diagnosis and treatment[J]. J Audiol Speech Pathol, 2013, 21(2):106-108.
[7] Moreno NS, Andre AP. Number of maneuvers need to get a negative dix-hallpike test[J]. Braz J Otorhinolaryngol, 2009, 77(5):650-653.
[8] 区永康, 梁象逢, 郑亿庆, 等. 不同变位试验在良性阵发性位置性眩晕的诊断价值[J]. 临床耳鼻咽喉科杂志, 2005, 19(22):1032-1034. OU Yongkang, LIANG Xiangfeng, ZHENG Yiqing, et al. Value of the different positioning tests in diagnosis of benign paroxysmal positional vertigo[J]. Clin J Otorhinolarynol Head Neck Surg, 2005, 19(22):1032-1034.
[9] Hanley K, ODowd T. Symptoms of vertigo in general practice: a prospective study of diagnosis[J]. Br J Gen Pract, 2002, 52(483):809-812.
[10] Daniel M. Kaplan, Youval Slovik, Be Zion Joshua, et al. Head shaking during Dix-Hallpike exam increases the diagnostic yield of posterior semicircular canal BPPV[J]. Otol Neurotol, 2013, 34(8):1444-1447.
[11] (英)普朗斯坦,(德)伦珀特. 赵刚, 韩军良, 等, 译. 眩晕和头晕: 实用入门手册[M]. 1版. 北京: 华夏出版社, 2012: 133.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed

DHM阴性的非典型PSC-BPPV诊断策略探讨

Exploration of diagnostic strategy for atypical PSC-BPPV with negative DHM.

HTML

PDF (PC)

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 8

多维度评价

本文评价

推荐阅读 0

[1]	鄢慧琴,王豪. 难治性良性阵发性位置性眩晕的临床分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 86-88.
[2]	李桂芳,王春华,张淑贞. 体位限制对手法复位后良性阵发性位置性眩晕的疗效观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 42-45.
[3]	鞠骏,李进让,邹世桢,贾曼玉. 创伤后良性阵发性位置性眩晕的临床特点及近期疗效研究[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 57-61.
[4]	王学海，张建新，孟昭进，刘秀玲. 上半规管良性阵发性位置性眩晕41例[J]. 山东大学耳鼻喉眼学报, 2014, 28(3): 47-50.
[5]	孙祥1，于亚峰2 . 继发性后半规管良性阵发性位置性眩晕的诊治[J]. 山东大学耳鼻喉眼学报, 2013, 27(5): 22-23.
[6]	王宁宁，李永团. 位置性眩晕的临床诊疗分析[J]. 山东大学耳鼻喉眼学报, 2013, 27(5): 24-27.
[7]	刘静波，刘建治，黄建民. 手法复位治疗良性阵发性位置性眩晕36例[J]. 山东大学耳鼻喉眼学报, 2010, 24(6): 17-19.
[8]	曹效平王天生顾东胜吴春平. 耳石复位法治疗良性阵发性位置性眩晕32例[J]. 山东大学耳鼻喉眼学报, 2009, 23(5): 10-12.