外周前庭疾病的诊断和治疗

doi:10.6040/j.issn.1673-3770.1.2020.074

摘要/Abstract

摘要： 眩晕是外周前庭疾病的主要表现之一,发病原因涉及多个学科,临床诊治较为困难。随着前庭功能检查技术的发展、对前庭疾病研究的不断深入,相关科研成果与日剧增并广泛应用于临床。近年来,随着前庭疾病国际分类标准制定和发布,各类前庭疾病诊断标准相继出台,治疗前庭疾病的药物、手术的相关规范日趋完善,加之前庭康复技术的飞速发展,使得对前庭疾病的诊疗越来越规范和精准。

关键词: 外周前庭疾病, 眩晕, 诊疗进展, 前庭功能检查, 前庭康复治疗

Abstract: Vertigo is one of the most important symptom of peripheral vestibular diseases which are difficult to differentially diagnose and manage because multiple disciplines are involved. The premise of effective management is accurate diagnosis of vestibular diseases. With the development of vestibular function examination technology and the deepening of vestibular disease research, great progress has been made in the diagnosis and management of vestibular diseases. The establishment and publication of international classification of vestibular diseases, the introduction of diagnostic standards for various vestibular diseases in the world, the formulation of vestibular disease drugs, surgical specifications and the rapid development of vestibular rehabilitation technology make the diagnosis and management of vestibular diseases more and more standardized and accurate.

Key words: Peripheral vestibular disease, Vertigo, Diagnosis and management, Vestibular function examination, Vestibular rehabilitation therapy

中图分类号:

R764.3

杨军,郑贵亮. 外周前庭疾病的诊断和治疗[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 1-6.

参考文献

[1] Walther LE. Current diagnostic procedures for diagnosing vertigo and dizziness[J]. GMS Curr Top Otorhinolaryngol Head Neck Surg, 2017, 18(16):Doc02. doi: 10.3205/cto000141.
[2] Strupp M, Mandalà M, López-Escámez JA. Peripheral vestibular disorders[J]. Curr Opin Neurol, 2019, 32(1):165-173. doi:10.1097/wco.0000000000000649.
[3] World Health Organization, International Classification of Diseases, 11th edition, https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1300772836.
[4] Bisdorff AR, Staab JP, Newman-Toker DE. Overview of the international classification of vestibular disorders[J]. Neurol Clin, 2015, 33(3):541-50, vii. doi:10.1016/j.ncl.2015.04.010.
[5] 中国医药教育协会眩晕专业委员会, 中国康复医学会眩晕与康复专业委员会, 中西医结合学会眩晕专业委员会, 等. 前庭功能检查专家共识(一)(2019)[J]. 中华耳科学杂志, 2019, 17(1):117-123. doi:10.3969/j.issn.1672-2922.2019.01.020.
[6] 中国医药教育协会眩晕专业委员会, 中国康复医学会眩晕与康复专业委员会, 中西医结合学会眩晕专业委员会, 等. 前庭功能检查专家共识(二)(2019)[J]. 中华耳科学杂志, 2019, 17(2):144-149. doi:10.3969/j.issn.1672-2922.2019.02.002.
[7] MacDougall HG, McGarvie LA, Halmagyi GM, et al. A new saccadic indicator of peripheral vestibular function based on the video head impulse test[J]. Neurology, 2016, 87(4):410-418. doi:10.1212/wnl.0000000000002827.
[8] Shepard NT, Jacobson GP. The caloric irrigation test[M] //Handbook of Clinical Neurology. Amsterdam: Elsevier, 2016:119-131. doi:10.1016/b978-0-444-63437-5.00009-1.
[9] Alhabib SF, Saliba I. Video head impulse test: a review of the literature[J]. Eur Arch Otorhinolaryngol, 2017, 274(3):1215-1222. doi:10.1007/s00405-016-4157-4.
[10] Rosengren SM, Colebatch JG, Young AS, et al. Vestibular evoked myogenic potentials in practice: Methods, pitfalls and clinical applications[J]. Clin Neurophysiol Pract, 2019, 4:47-68. doi:10.1016/j.cnp.2019.01.005.
[11] Zamora EG, Araújo PE, Guillén VP, et al. Parameters of skull vibration-induced nystagmus in normal subjects[J]. Eur Arch Otorhinolaryngol, 2018, 275(8):1955-1961. doi:10.1007/s00405-018-5020-6.
[12] Chabbert C. Principles of vestibular pharmacotherapy[M] //Handbook of Clinical Neurology. Amsterdam: Elsevier, 2016: 207-218. doi:10.1016/b978-0-444-63437-5.00014-5.
[13] Strupp M, Kremmyda O, Brandt T. Pharmacotherapy of vestibular disorders and nystagmus[J]. Semin Neurol, 2013, 33(3):286-296. doi:10.1055/s-0033-1354594.
[14] Soto E, Vega R. Neuropharmacology of vestibular system disorders[J]. Curr Neuropharmacol, 2010, 8(1):26-40. doi:10.2174/157015910790909511.
[15] Huppert D, Strupp M, Mückter H, et al. Which medication do I need to manage dizzy patients?[J]. Acta Otolaryngol, 2011, 131(3):228-241. doi:10.3109/00016489.2010.531052.
[16] Hain TC, Uddin M. Pharmacological treatment of Vertigo[J]. CNS Drugs, 2003, 17(2):85-100. doi:10.2165/00023210-200317020-00002.
[17] Lepcha A, Amalanathan S, Augustine AM, et al. Flunarizine in the prophylaxis of migrainous vertigo: a randomized controlled trial[J]. Eur Arch Otorhinolaryngol, 2014, 271(11):2931-2936. doi:10.1007/s00405-013-2786-4.
[18] Ramos Alcocer R, Ledezma Rodríguez JG, Navas Romero A, et al. Use of betahistine in the treatment of peripheral Vertigo[J]. Acta Otolaryngol, 2015, 135(12):1205-1211. doi:10.3109/00016489.2015.1072873.
[19] Sokolova L, Hoerr R, Mishchenko T. Treatment of vertigo: a randomized, double-blind trial comparing efficacy and safety of Ginkgo biloba extract EGb 761 and betahistine[J]. Int J Otolaryngol, 2014, 2014: 682439. doi:10.1155/2014/682439.
[20] 陈太生, 王巍, 徐开旭, 等. 良性阵发性位置性眩晕及其诊断治疗的思考[J]. 山东大学耳鼻喉眼学报, 2019, 33(5):1-5. doi:10.6040/j.issn.1673-3770.1.2019.053. CHEN Taisheng, WANG Wei, XU Kaixu, et al. Thoughts on benign paroxysmal positional Vertigo and its diagnosis and treatment[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5):1-5. doi:10.6040/j.issn.1673-3770.1.2019.053.
[21] Liu YP, Yang J, Duan ML. Current status on researches of Menieres disease: a review[J]. Acta Otolaryngol, 2020, 140(10):808-812. doi:10.1080/00016489.2020.1776385.
[22] Guyot JP, Perez Fornos A. Milestones in the development of a vestibular implant[J]. Curr Opin Neurol, 2019, 32(1):145-153. doi:10.1097/wco.0000000000000639.
[23] Guinand N, van de Berg R, Cavuscens S, et al. The video head impulse test to assess the efficacy of vestibular implants in humans[J]. Front Neurol, 2017, 8:600. doi:10.3389/fneur.2017.00600.
[24] Sulway S, Whitney SL. Advances in vestibular rehabilitation[J]. Adv Otorhinolaryngol, 2019, 82:164-169. doi:10.1159/000490285.
[25] Dunlap PM, Holmberg JM, Whitney SL. Vestibular rehabilitation: advances in peripheral and central vestibular disorders[J]. Curr Opin Neurol, 2019, 32(1):137-144. doi:10.1097/wco.0000000000000632.
[26] Meldrum D, Jahn K. Gaze stabilisation exercises in vestibular rehabilitation: review of the evidence and recent clinical advances[J]. J Neurol, 2019, 266(suppl 1):11-18. doi:10.1007/s00415-019-09459-x.
[27] Hall CD, Herdman SJ, Whitney SL, et al. Vestibular rehabilitation for peripheral vestibular hypofunction: an evidence-based clinical practice guideline: FROM THE AMERICAN PHYSICAL THERAPY ASSOCIATION NEUROLOGY SECTION[J]. J Neurol Phys Ther, 2016, 40(2):124-155. doi:10.1097/npt.0000000000000120.
[28] Klatt BN, Carender WJ, Lin CC, et al. A conceptual framework for the progression of balance exercises in persons with balance and vestibular disorders[J]. Phys Med Rehabil Int, 2015, 2(4):1044.
[29] Allum JHJ, Honegger F. Vibro-tactile and auditory balance biofeedback changes muscle activity patterns: possible implications for vestibular implants[J]. J Vestib Res, 2017, 27(1):77-87. doi:10.3233/ves-170601.
[30] Pavlou M, Kanegaonkar RG, Swapp D, et al. The effect of virtual reality on visual Vertigo symptoms in patients with peripheral vestibular dysfunction: a pilot study[J]. J Vestib Res, 2012, 22(5,6):273-281. doi:10.3233/ves-120462.
[31] Alahmari KA, Sparto PJ, Marchetti GF, et al. Comparison of virtual reality based therapy with customized vestibular physical therapy for the treatment of vestibular disorders[J]. IEEE Trans Neural Syst Rehabil Eng, 2014, 22(2):389-399. doi:10.1109/tnsre.2013.2294904.
[32] Meldrum D, Herdman S, Vance R, et al. Effectiveness of conventional versus virtual reality-based balance exercises in vestibular rehabilitation for unilateral peripheral vestibular loss: results of a randomized controlled trial[J]. Arch Phys Med Rehabilitation, 2015, 96(7):1319-1328.e1. doi:10.1016/j.apmr.2015.02.032.
[33] Clark RA, Bryant AL, Pua YH, et al. Validity and reliability of the Nintendo Wii Balance Board for assessment of standing balance[J]. Gait Posture, 2010, 31(3):307-310. doi:10.1016/j.gaitpost.2009.11.012.
[34] 杨军, 郑贵亮. 进一步重视前庭康复[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(3):204-206. doi:10.13201/j.issn.1001-1781.2019.03.004. YANG Jun, ZHENG Guiliang. Further emphasis on vestibular rehabilitation[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2019, 33(3):204-206. doi:10.13201/j.issn.1001-1781.2019.03.004.

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