主观性良性阵发性位置性眩晕的临床表现和治疗

目的 探讨主观性良性阵发性位置性眩晕临床表现和治疗.方法 回顾性分析2003年1月至2006年9月诊治的12例主观性良性阵发性位置性眩晕患者的临床表现和治疗结果,与24例客观性后半规管良性阵发性位置性眩晕比较.结果 主观性良性阵发性位置性眩晕临床表现为由头位改变诱发的短暂眩晕发作,而Dix-Hallpike诱发试验未见相应的眼震,主观性良性阵发性位置性眩晕发作的潜伏期(-x±s,下同)为(4.42±2.02)s,持续时间(-x±s,下同)为(8.67±4.31)s,而客观性后半规管良性阵发性位置性眩晕组分别为(3.20±1.18)s和(14.75±4.97)s,差异均有统计学意义(t=2.30,P＜0.05;t=3.61,P＜0.01).主观性良性阵发性位置性眩晕组首次治疗成功率为91.7%(11/12),客观性后半规管良性阵发性位置性眩晕首次治疗成功率为79.2%(19/24),两者差异无统计学意义;所需的颗粒复位手法次数主观性良性阵发性位置性眩晕组为(1.75±1.08)次(-x±s,下同),客观性后半规管良性阵发性位置性眩晕组为(3.38±1.06)次,差异具有统计学意义(t=4.32,P＜O.01).随访5～29个月,主观性良性阵发性位置性眩晕组2例复发,客观性后半规管良性阵发性位置性眩晕组7例复发,两者差异无统计学意义.结论 主观性良性阵发性位置性眩晕与客观性后半规管良性阵发性位置性眩晕相比,前者眩晕发作潜伏期长、持续时间短,治疗所需的循环数更少,前者治疗结果优于后者.

Clinical features and therapy of subjective benign paroxysmal positional vertigo

OBJECTIVE: To evaluate the clinical features and therapy of subjective benign paroxysmal positional vertigo (S-BPPV). METHODS: By retrospectively analyzing the results of clinical features and therapy in 12 patients with S-BPPV from January 2003 to September 2006, the results were compared with 24 patients with objective benign paroxysmal positional vertigo (O-BPPV) of posterior semicircular canal. RESULTS: S-BPPV patients suffered from attack of transient vertigo with sudden onset triggered by head motion but no concomitant nystagmus in Dix-Hallpike test. The latency and duration of vertigo attack were (4.42 +/- 2.02) s and (8.67 +/- 4.31) s in S-BPPV, (3.2 +/- 1.18) s and (14.75 +/- 4.97) s in O-BPPV of posterior semicircular canal. The differences between the two groups were all significant (t = 2.30, P < 0.05 and t = 3.61, P < 0.01). The symptoms disappeared in 11 patients after a single therapy of particular repositioning maneuver and 1 patient after 2 times therapy in S-BPPV. The one-stage success rate was 91.7% in S-BPPV and 79.2% in O-BPPV of posterior semicircular canal, but the difference between these two groups was not significant. The number of circulation therapy in first management was (1.75 +/- 1.08) times in S-BPPV and (3.38 +/- 1.06) times in O-BPPV of posterior semicircular canal, while the difference was significant (t = 4.32, P < 0.01). There were 2 patients recurred during follow-up in S-BPPV and 7 patients in O-BPPV of posterior semicircular canal, but the difference wasn't significant. CONCLUSIONS: Longer latency, shorter duration and need less circulation therapy are achieved in S-BPPV compared with O-BPPV of posterior semicircular canal, which indicate that the effectiveness of S-BPPV seems to be more favorable than that of O-BPPV of posterior semicircular canal.