伴有眩晕的突发性聋眩晕的临床特点分析

目的 分析突发性聋伴发的眩晕的临床特点.方法 回顾性分析2005年1月至2009年7月就诊于解放军总医院眩晕中心的伴发作性眩晕的突发性聋患者96例的临床资料,突发性聋及良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的诊断根据中华医学会颁布的指南.分析其前庭功能特点及前庭与耳蜗症状出现的时间关系.结果 96例患者中BPPV23例(24.O%);余73例患者中一侧前庭功能低下者58例(60.4%),前庭功能正常者15例(15.6%).96例患者中46例患者可以提供准确的耳蜗症状与眩晕出现的时间:其中6例(13.0%)耳蜗症状与眩晕同时出现;耳蜗症状与眩晕出现的间隔时间＜1 h者4例(8.7%);1 h≤间隔时间＜24 h者21例(45.7%);13例(28.3%)在耳蜗症状出现数天后出现眩晕,最长为10 d;仅有2例(4.3%)眩晕的出现早于耳蜗症状.结论 突发性聋伴发的眩晕可以表现为前庭功能正常或低下,部分患者可以表现为BPPV,且耳蜗症状一般早于前庭症状出现.

Analysis of clinical features of concomitant vertigo in idiopathic sudden deafness

Objective To analyze the clinical characteristics of concomitant vertigo in patients with sudden deafness (SD). Methods Ninety-six cases of SD were reviewed retrospectively from January 2005to July 2009. SD and benign paroxysmal positional vertigo (BPPV) were diagnosed according to the guides of China Medical Association. The characteristics of vestibular function and the order of the onset of cochlear and vestibular symptoms were analyzed. Results Of all 96 cases, 23 (24.0%) cases presented with BPPV;58(60.4% ) cases took the form of unilateral vestibular hypofunction and 15( 15.6% ) cases had normal vestibular function. Time interval between cochlear and vestibular symptoms was as follows: 46 patients could tell the exact time of onset of cochlear and vestibular symptoms, of which 6( 13.0% ) cases occurred simultaneously; 4 (8. 7% ) cases presented vertigo within 1 hour after onset of cochlear symptomar hypofunction; 21 (45.7%)cases showed time interval between 1 hour and 24 hours; and 13 (28.3%) cases presented vertigo at several days( less than 10 days) after cochlear symptoms. And only in 2 (4.3%) cases did vertigo occur before cochlear symptoms. Conclusions Concomitant vertigo in idiopathic SD took the forms of normal or abnormal vestibular function, some of which were BPPV. Occurrence of vertigo was after cochlear symptoms.