良性阵发性位置性眩晕患者裸眼及视频眼震图下眼震特征及定位诊断分析

目的探讨裸眼及视频眼震图(videonystagmograph,VNG)下观察良性阵发性位置性眩晕(benign positional paroxysmal vertigo,BPPV)患者眼震及诊断结果的差异。方法108例BPPV患者分别进行Dix-Hallpike和滚转试验(Roll),应用红外视频眼震电图仪观察眼震特点,进行定位诊断,并与裸眼下观察其眼震特征及诊断结果进行比较。结果 108例患者中共诊断后半规管BPPV(PSC-BPPV)75例(69.44%,75/108),裸眼及VNG辅助下典型眼震检出率分别为66.67%(50/75)和93.33%(70/75);前半规管BPPV(ASC-BPPV)18例(16.67%,18/108),裸眼及VNG下典型眼震检出率分别为72.22%(13/18)和100%(18/18),两者差异均有统计学意义(P<0.05);水平半规管BPPV(HSC-BPPV)9例(8.33%),裸眼及VNG辅助下分别正确诊断7例和9例;混合型BPPV6例(5.56%),裸眼及VNG辅助下分别正确诊断3例和6例。结论 VNG能够客观地记录BPPV患者的眼震情况,有助于提高眼震的检出率及诊断的准确性。

The Observation and Diagnosis of 108 Patients with Benign Positional Paroxysmal Vertigo with Naked Eyes and VNG

Objective The VNG has played an important role in the diagnosis and treatment of the benign positional paroxysmal vertigo(BPPV).This article intends to compare the differences of detection rate of nystagmus between naked eyes and VNG. Methods 108 BPPV cases from July 2010 to June 2011 were reviewed and the findings of Dix-Hallpike and Roll test with Frenzel were compared to those obtained with naked eyes simply. Results 75(69.44%) cases of patients with PSC-BPPV and 18(16.67%) cases with ASC-BPPV were clinically diagnosed through observation and VNG.By comparison, observation with naked eyes and VNG yielded 66.67% and 93.33% for PSC-BPPV and 72.22% and 100% for ASC-BPPV,respectively.There were statistical differences between the two methods(P<0.05). Conclusion VNG can objectively record the nystagmus of BPPV patients,thus allowing more accurate diagnosis with the ability to keep the results for further analysis.