正中悬头位Dix-Hallpike法诊断良性阵发性位置性眩晕

The Use of Center Head hanging Dix-Hallpik in the Diagnosis of Benign Paroxysmal Positional Vertigo

目的评价正中悬头位Dix-Hallpike诱发检查法在诊断后半规管良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)中的意义。方法回顾性总结广东省人民医院耳鼻咽喉科眩晕门诊2008年4月1日到5月29日根据经典或者正中悬头位Dix-Hallpike法诊断为后半规管BPPV患者28例的临床资料,均首先进行正中悬头位Dix-Hallpike诱发试验,如结果为阴性后继续行经典Dix-Hallpike检测证实为后半规管性BPPV。比较正中悬头位Dix-Hallpike相对于经典Dix-Hallpike的阳性率。结果28例后半规管BPPV患者中,正中悬头位Dix-Hallpike诱发试验相对于经典Dix-Hallpike诱发实验的阳性率为78.57%(22/28)。结论正中悬头位Dix-Hallpike法诊断BPPV可以有效地简化诊治程序,并减轻部分患者诱发的眩晕及眼震强度,具有一定的临床意义。但由于其阳性率低于经典方法,故在临床上不能完全代替经典方法。

Objective To assess the application of the center head hanging Dix- Hallpike test in the diagnosis of the benign paroxysmal positional vertigo （BPPV） of posterior semicircular canal. Methods Twentyeight cases of posterior canal BPPV diagnosed by the traditional or center head hanging Dix-Hallpike test from April 1^st to May 29^th, 2008 were retrospectively discussed. All of the patients were tested by the center head hanging Dix- Hallpike test first, if the vertigo and torsional nystagmus were not induced, then the traditional Dix-Hallpike test was performed. The positive rate of center head hanging Dix-Hallpik test compared to the traditional test was calculated. Results The positive rate of center head hanging Dix-Hallpik test compared to the traditional test was 78. 57%（22/28） in the total 28 cases of posterior canal BPPV. Conclusion The center head hanging Dix-Hallpike test can simplify the procedure of diagnosis of posterior canal BPPV, and it can reduce the severity of the vertigo in some patients to facilitate the Epley maneuver. However,it cannot replace the traditional mothods completely due to the lower positive rate compared to the traditional methods.