山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (6): 11-13.doi: 10.6040/j.issn.1673-3770.0.2015.486

• 论著 • 上一篇    下一篇

后半规管良性阵发性位置性眩晕急性发作时的临床表现

刘学升,李筱瑜,邓玮   

  1. 青岛市市立医院神经内科, 山东 青岛 266011
  • 收稿日期:2015-11-17 出版日期:2016-12-16 发布日期:2016-12-16
  • 通讯作者: 邓玮. E-mail:deng64-wei128@163.com E-mail:yung92-lay22@163.co
  • 作者简介:刘学升. E-mail:yung92-lay22@163.co

The clinical manifestations of posterior semicircular canal benign paroxysmal positional vertigo at the time of acute onset.

LIU Xuesheng, LI Xiaoyu, DENG Wei   

  1. Department of Neurology, the Qingdao Municipal Hospital, Qingdao 266011, Shandong, China
  • Received:2015-11-17 Online:2016-12-16 Published:2016-12-16

摘要: 目的 观察和总结后半规管良性阵发性位置性眩晕(PSC-BPPV)急性发作时的临床特征,为临床诊断提供依据。 方法 回顾性分析115例PSC-BPPV患者急性发作时的临床表现,分析并总结患者的性别和年龄分布、发病时状态、头晕性质、眩晕发作与头部活动间的关系、眼震、伴随症状、辅助检查等临床特征。 结果 PSC-BPPV急性发作时的临床表现具有以下特征:(1)女性多于男性;(2)易累及50岁以上人群;(3)在起床、躺卧、翻身或活动中头部主动或被动到某一位置时突然发病,特别是晨起发病居多;(4)剧烈的眩晕伴有恶心、呕吐;(5)部分患者在初次查体时表现出旋转性眼震;(6)不伴有耳蜗和神经系统症状和体征;(7)颅脑影像学检查无阳性相关发现。 结论 急诊时如患者在起床、躺下、翻身或头部活动到某一位置时突然出现剧烈的眩晕发作,不伴有耳蜗和神经系统症状体征,颅脑影像学检查无相关阳性发现,应当考虑PSC-BPPV的诊断,及早行Dix-Hallpke诱发试验能够确立诊断。

关键词: 良性自发性位置性眩晕, 临床特征, 急诊, 后半规管, 急性期

Abstract: Objective To observe and summarize the clinical characteristics of posterior semicircular canal benign paroxysmal positional vertigo(PSC-BPPV)at the time of acute onset, and to provide the clinical evidences for earlier diagnosis. Methods The clinical manifestations at the time of acute onset of 115 cases of patients with PSC-BPPV diagnosed were collected retrospectively. The gender, distributions of age, character of dizziness, state of patients at the time of acute onset, relationships between vertigo attack and head movement, nystagmus, associated symptoms, and auxiliary examination were analyzed. Results The clincal characteristics of PSC-BPPV at the time of acute onset were summarized as follow:(1) incidence among female patients was more higher than that of male patients; (2) participants aged over 50 years-old were more vulnerable to be affected;(3) acute vertigo occurred mainly at time of getting up, lying down, turning over or moving head actively or passively to a certain position, especially getting up in the morning; (4) the onset of severe vertigo was associated with nausea and vomitting; (5) part of patients presented characteric rotatory nystagmus of PSC-BPPV at the time of initial routine physical examination; (6) without symptoms and signs of cochlear and nervous system; (7) without related positive findings by cranial imaging(CT or MRI). Conclusion The diagnosis of PSC-BPPV should be considered if patients presented vertigo attack suddenly but without symptoms and signs of coclear and nervous system and related positive findings by cranial imagings. It is helpful to earlier confirming of the diagnosis by performing Dix-Hallpike manuvre.

Key words: Benign paroxysmal positional vertigo, Clinical characteristics, Emergency, Acute stage, Posterior semicircular canal

中图分类号: 

  • R764
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