闭目原地踏步试验对头晕/眩晕患者病因筛查的诊断价值

目的：探讨闭目原地踏步试验对头晕/眩晕初步病因筛查的诊断价值。方法对564例头晕/眩晕患者采用原地闭目踏步试验、眼球震颤检测、Dix-Hallpike 试验,分析闭目原地踏步试验对头晕/眩晕病因初步筛查的诊断价值。结果本组患者闭目原地踏步试验发生倾倒72例(12.8%),其中合并眼球震颤68例(94.4%),诊断为：前庭周围病变59例,其他13例；偏向一侧310例(55.0%),其中合并眼球震颤43例,Dix-Hallpike 阳性102例,诊断为：位置性眩晕41例、前庭周围病变4例、复发性前庭病168例、椎基底动脉供血不足50例、精神性头晕26例、其他原因21例；踏步试验阴性182例(32.3%),Dix-Hallpike 阳性96例,诊断为：位置性眩晕94例、精神性头晕58例、椎基底动脉供血不足12例、复发性前庭病6例,其他12例。头晕/眩晕前庭周围病变、复发性前庭病、椎基底动脉供血不足患者闭目原地踏步试验多为阳性表现(χ2=34.97、58.18、16.20,P <0.01),而位置性眩晕、精神性头晕患者多为阴性表现(χ2=14.11、8.26,P<0.01)。结论闭目原地踏步试验结合眼球震颤、Dix-Hallpike 检查是快速筛查头晕/眩晕患者初步病因的有效方法。

Diagnostic values of Unterberger test in etiology screening of patients with dizziness/vertigo

Objective To explore the diagnostic values of Unterberger test in etiology screening of patients with dizziness/vertigo.Methods Unterberger,nystagmus and Dix-Hallpike test were carried out in 564 patients with dizziness and vertigo and diagnostic values of Unterberger test in etiology screening of dizzi-ness and vertigo analyzed.Results During Unterberger test dumping occurred in 72 patients (12.8%), dumping complicated with nystagmus did in 68 ones (94.4%),59 ones were diagnosed as vestibular pe-ripheral lesions and 13 other;310 patients dumped to one side (55.0%),dumping complicated with nys-tagmus did in 43 ones,Dix-Hallpike tests were positive in 102 ones,41 ones were diagnosed as positional vertigo,4 vestibular peripheral lesions,1 68 recurrent vestibulopathy,50 vertebro-basilar artery insuffi-ciency (VBI),26 psychic dizziness,and 21 other;Unterberger tests were negative in 182 (32.3%)and Dix-Hallpike positive 96,94 ones were diagnosed as positional vertigo,58 psychic dizziness,12 VBI,6 re-current vestibulopathy,and 12 other.Unterberger tests of patients with dizziness/vertigo caused by ves-tibular peripheral lesions,recurrent vestibulopathy and VBI were positive,those of positional vertigo and psychic dizziness negative.Conclusion Unterberger test in combination with nystagmus and Dix-Hallpike test is a quick and effective method to screen initial causes of dizziness/vertigo patients.