后半规管良性阵发性位置性眩晕患者复位中眼震分析

目的 分析后半规管良性阵发性位置性眩晕(posterior semicircular canal benign paroxysmal positional vertigo,PC-BPPV)患者复位中的眼震,探讨BPPV可能的发病机制.方法 2007年12月至2008年4月眩晕门诊就诊的66例PC-BPPV患者,详细记录病史、体位试验及复位中不同位置眼震的情况,对PC-BPPV患者可能发病机制进行探讨.结果 变位试验完伞符合贵阳会议诊断标准的66例PC-BPPV患者,采用改良Epley复位,视频眼震记录技术记录复位中四个位置的眼震方向及强度,24例患者复位中出现的眼震均为垂直扭转向上眼震;21例除第一个位置出现上向扭转眼震,其余三个位置眼震阴性;7例变位试验初诊PC-BPPV的患者在第二次复位中出现强烈水平眼震;14例患者复位的第二或第三个位置出现下向垂直眼震.由复位中不同位置出现的眼震分析,66例确诊为PC-BPPV的患者,52例复位中的表现符合管石及嵴顶耳石症理论,占78.8%.结论 除了目前公认的管石症及嵴顶耳石症理论外,推测部分PC-BPPV可能与耳石器官及球囊椭圆囊神经病变有关.

Different pathogenesls of benign paroxysmal positional vertigo from the nystagmus during particle repositioning maneuver

Objective To analyze the nystagmus during particle repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV), and verify different pathogenesis of benign paroxysmal positional vertigo(BPPV). Methods The chief complains, nystagmus during positioning test and particle repositioning maneuver(PRM) were recorded in detail from 66 PC-BPPV cases during Dec. 2007 and Apr. 2008, and verifying possible pathogenesis of BPPV was based on nystagmus. Results Of all 66 PC-BPPV cases, the four positions of PRM were found in 24 cases presented upward torsional nystagmus at the second or third position, 21cases presented negative nystagmus except the first position, 7 cases presented intensity horizontal nystagmus during PRM and 14 cases presented downward nystagmus at the second or third position during PRM. Of all 66 cases, 78.8% of them were accord with canalithiasis and cupulolithiasis while the other may be related with otolith organ or nerve disease. Conclusions Besides canalithiasis and cupulolithiasis, part of BPPV may be related with otolith organ or nerve disease.