水平半规管良性发作性位置性眩晕的临床研究

Clinical study of horizontal canal benign paroxysmal positional vertigo

目的探讨水平半规管良性发作性位置性眩晕(HCBPPV)的临床特点和治疗方法。方法回顾性分析27例HCBPPV患者的临床资料及Barbecue翻滚法耳石复位治疗的疗效。结果27例HCBPPV患者眩晕发作具有短暂性、变位性、潜伏期、无疲劳性的特点,平卧侧头时21例见水平向下性眼震,6例为水平向上性眼震。给予Barbecue翻滚法耳石复位治疗后,水平向下性眼震患者症状全部消失,水平向上性眼震患者症状未缓解。结论根据临床特点和平卧侧头试验可确诊HCBPPV,水平向下性眼震与半规管耳石症相关,水平向上性眼震与壶腹嵴帽耳石症相关,Barbecue翻滚法对出现水平向下性眼震的HCBPPV有特效。

Objective To study the clinical features and treatment of horizontal canal benign paroxysmal positional vertigo （HC-BPPV）. Methods The clinical features of 27 patients with HC-BPPV and the treatment results with otolith repositioning maneuver of Barbecue rotation were analyzed retrospectively. Results All the patients with HC-BPPV had vertigo attack and this kind of vertigo attack presented with some characters such as brief, positioning, latency and no fatigability. Geotropie nystagmus was seen in 21 patients and apogeotropic nystagmus was seen in 6 patients when head was turned to either side in supine position. After Barbecue rotation, all symptoms disappeared in patients with geotropic nystagmus and did not change in patients with apogeotropic nystagmus. Conclusions The diagnosis of HC-BPPV is based on typical clinical features and test of turning head to either side in supine position. Geotropic nystagmus is associated with canalithiasis and apogeotropic nystagmus is associated with cupulolithiasis, and the therapy of Barbecue rotation is very effective to HC-BPPV patients with geotropic nystagmus.