针刀松解寰枕筋膜治疗颈源性眩晕的疗效研究

目的:研究针刀松解寰枕筋膜治疗颈源性眩晕的疗效。方法:选取2017年1月至2018年1月佛山市健翔医院收治的颈源性眩晕患者96例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组48例。对照组患者给予3次/周针灸、局部按摩治疗,观察组患者给予1次/周的针刀松解寰枕筋膜治疗,均治疗3周。依照《颈性眩晕评估量表(ESCV)》分析2组患者治疗前后颈性眩晕评分变化、椎动脉血流动力学变化,比较2组患者血清中内皮源性超极化因子(EDHF)的含量和一氧化氮(NO)水平,统计2组患者的治疗有效率、眩晕症状缓解时间及生命质量变化。结果:观察组患者治疗后总有效率为97.92%高于对照组的81.25%(P<0.05),眩晕有效缓解时间明显缩短,眩晕评分显著高于对照组(P<0.05);观察组患者治疗后椎动脉的平均血流、收缩期血流、舒张期血流速度、血清中NO及EDHF水平明显上升,血管搏动指数显著下降(P<0.05);生命质量评分显著升高(P<0.05)。结论:针刀松解寰枕筋膜能够通过改善颈源性眩晕患者的椎动脉血流动力学,有效治疗患者的颈源性眩晕。     

Cerebellar artery infarction with sudden hearing loss and vertigo as initial symptoms: A case report

BACKGROUNDSudden hearing loss (SHL) is associated with serious systematic conditions such as neoplasms, vascular events, autoimmune diseases, infections, and iatrogenic injury. Some authors report that SHL can be an early warning sign of impending vertebrobasilar ischemic stroke. It is important to distinguish stroke from benign disease. CASE SUMMARYA 48-year-old male patient presented with SHL and vertigo as first symptoms. Diffusion-weighted imaging revealed high signal intensity in the left posterior inferior cerebellar artery territory of the cerebellar hemisphere and high signal intensity in the right pons and bridge cerebellar arm, confirming that the patient had cerebral infarction. Treatment with antiplatelet drugs, steroid anti-inflammatory drugs, and neurotrophic nerve therapy promoted blood circulation and removed blood stasis, and the symptoms of the patient were significantly improved. CONCLUSIONSHL and vertigo could be the initial symptoms of vertebrobasilar ischemic stroke.     

Guidelines of the French Society of Otorhinolaryngology (SFORL) for teleconsultation in patients with vertigo during the COVID-19 pandemic

ObjectivesIn the context of the SARS-CoV-2 pandemic, patients may have been dissuaded from seeking consultation, thus exposing themselves to a risk of loss of chance. This guide aims to define how teleconsultation can assist in assessing vertiginous adults or children, and to gather the information needed to provide quick medical care.MethodsThese recommendations rely on the authors’ experience as well as on literature. A survey on otoneurologic approach via telemedicine has been conducted based on a literature search until March 2020.ResultsThe first clinical assessment of the vertiginous patient via teleconsultation can only be successful if the following conditions are met: initial contact to verify the feasibility of the assessment at a distance, the presence of a caregiver in order to assist the patient, the possibility of making video recordings. Medical history via telemedicine, as in a face-to-face assessment, allows to assess the characteristics, duration, frequency, and potential triggering factors of the vertigo, in both children and adults. During teleconsultation, the following tests can be carried out: oculomotricity evaluation, assessment of balance, simple neurological tests, checking for positional vertigo/nystagmus and, eventually to perform canalith-repositioning procedures. In children, the following should be searched for: history of hearing or visual impairment, a context of fever or trauma, otorrhea, signs of meningeal irritation.ConclusionThe neurotologic telemedicine relies on the accuracy of the clinical assessment, which is based on history taking and a few simple tests, encouraging the development of a decision-making algorithm adapted for teleconsultation. However, the latter has its limitations during an emergency examination of a new patient presenting vertigo, and, at least in some cases, cannot replace a face-to-face consultation. Teleconsultation is often adapted for follow-up consultations of previously selected vertiginous patients during face-to-face assessment.     

丁苯酞联合长春西汀治疗椎动脉优势型后循环缺血性眩晕的疗效及安全性分析

【目的】探讨丁苯酞联合长春西汀治疗椎动脉优势型后循环缺血性眩晕（PCIV）的有效性与安全性。【方法】将本院2014年1月至2015年10月收治的椎动脉优势型PCIV患者82例随机分为观察组及对照组两组,每组各41例。对照组应用篝春西汀治疗,观察组应用丁苯酞联合长春西汀治疗,对比两组的临床疗效与副作用。【结果】观察组治愈率及总有效率（48．78％、92．68％）显著高于对照组（29．27％、80．49％）;治疗后观察组的双侧椎动脉（LVA、RLA）、双侧大脑后动脉（LPCA、RPCA）及基底动脉（BA）的平均血流速度（Vm）显著高于对照组,而血液流变学指标（WBV、PV、PAI）显著低于对照组,差异均具有统计学意义（P〈0．05）。【结论】丁苯酞联合长春西汀治疗PCIV疗效确切且用药安全,能够有效改善患者的血液流变学以及后循环缺血症状。     

复方天麻蜜环糖肽片联用甲磺酸倍他司汀片治疗颈性眩晕

目的：观察复方天麻蜜环糖肽片联用甲磺酸倍他司汀片治疗颈性眩晕的疗效。方法：将94例以眩晕为主要症状的颈椎病患者,随机分为两组。治疗组47例,用复方天麻蜜环糖肽片联用甲磺酸倍他司汀片;对照组47例,单纯用甲磺酸倍他司汀片治疗,疗程为14d。结果：治疗组总有效率93.6%,显效率70.2%;对照组总有效率87.2%,显效率51.1%。治疗组治疗后血脂和血流变学明显改善。结论：复方天麻蜜环糖肽片联用甲磺酸倍他司汀片治疗颈性眩晕的疗效高于单用甲磺酸倍他司汀片。