离地性眼震水平半规管BPPV诊治策略

目的 探讨离地性眼震水平半规管良性阵发性位置性眩晕(HC-BPPV)的诊治策略.方法 回顾性分析2017年7月～2019年6月确诊的48例离地性眼震HC-BPPV患者的临床资料,均采用滚转试验(roll test)、低头仰头试验(bow and lean test)等方法判断侧别,通过Gufoni法、Barbecue法...

Strategy in the Diagnosis and Treatment of Horizontal Semicircular Canal BPPV with Apogeotropic Nystagmus

Objective To summarize the experience of diagnosis and treatment of horizontal semicircular canal benign paroxysmal positional vertigo(HC-BPPV)with apogeotropic nystagmus.Methods The clinical data of 48 patients with apogeotropic nystagmus diagnosed in our department from July 2017 to June 2019 were analyzed retrospectively.The roll test,bow and lean test was used to judge the affected side.The Gufoni maneuver,Barbecue maneuver,Head shaking maneuver and FPP were used to determine the position and reposition of otolith.The clinical effects were observed.Results A total of 48 patients were treated by canalith repositionin maneuver.At the first diagnosis,31 cases were converted to geotropic nystagmus by Gufoni and Head shaking,30 patients symptoms were disappeared and 1 patient was relieved by Barbecue maneuver.The other 17 cases that did not converted geostrophic nystagmus were treated by vestibular inhibitor,Barbecue and FPP maneuver.On the 3rd day,31 patients who turned to geotropic nystagmus,only one case still had geotropic nystagmus,the Barbecue maneuver made the symptoms disappear.Another 17 cases,8 cases converted to geotropic nystagmus,2 cases with Gufoni.The 10 cases were relieved by Barbecue maneuver.One case of Gufoni reduction vertigo nystagmus immediately.One case of Gufoni was still with apogeotropic nystagmus was treated by Head shaking acclimatization and FPP.And five cases did not induce vertigo and nystagmus.1w follow-up,symptoms disappeared in all patients.Conclusion The most important thing in the diagnosis and treatment of the HC-BPPV with apogeotropic nystagmus is to determine the location of otolith by nystagmus transformation,multiple maneuver to improve the efficacy,shorten the course of the disease.