以持续性眩晕为表现的水平半规管良性阵发性位置性眩晕的诊治

目的　探讨以持续性眩晕为表现的良性阵发性位置性眩晕（benign paroxysmal positional vertigo，BPPV）患者的诊治。方法　回顾性分析2例以持续性眩晕为表现的BPPV患者的临床资料。结果　此2例患者在坐位及平躺位见方向向患侧的水平自发持续性眼震，甩头试验健侧阳性，平卧侧头试验双侧均诱发出水平离地性眼震，平躺后头部向患侧连续转360°时分别出现2个眼震消失点和2个眼震最强点，给予手法复位后患者眩晕症状缓解。结论　水平半规管BPPV患者偶可表现为持续性眩晕发作，其病因为壶腹嵴帽耳石症，临床表现与耳石重力因素和水平半规管空间位置相关。

Diagnosis and treatment of persistent vertigo due to horizontal semicircular canal benign paroxysmal positional vertigo

OBJECTIVE To explore the diagnosis and treatment of benign paroxysmal positional vertigo which present as persistent vertigo. METHODS Analyzed the clinical data of 2 cases with horizontal semicircular canal benign paroxysmal positional vertigo presented as persistent vertigo, retrospectively. RESULTS The two cases showed persistent spontaneous horizontal nystagmus beating towards the affected side in sitting and lying position, head thrust test were positive on the unaffected side and were exhibited apogeotropic nystagmus on both sides in roll test. In the process of head turning 360° towards the affected side in lying position, we detected two nystagmus vanishing points and two nystagmus strongest points. The symptoms were resolved with maneuver therapy. CONCLUSIONCupulolithiasis can occasionally present as persistent vertigo, the manifestation is related to the gravity of otolith and the position of horizontal semicircular canal.