周围前庭阵发症七例的临床与影像学分析

Clinical manifestations and imaging features of peripheral vestibular paroxysmia： a report of 7 cases

目的报道7例周围前庭阵发症（PVP）患者的临床及影像学检查资料，介绍PVP的临床特点、影像学发现；探讨PVP的可能机制。方法对2006年10月到2008年1月收集的7例临床确诊的PVP患者的临床表现、影像学资料进行全面分析。结果7例PVP患者的临床特点为：（1）均存在反复发作的头晕或眩晕；（2）在头位突然变动时出现短暂头晕或眩晕是最突出的症状；（3）7例患者头颅MRTA显示存在血管和第Ⅷ颅神经交叉征象；（4）经卡马西平或盐酸氟桂利嗪治疗可使发作减轻、消失。结论PVP的发病可能与血管交叉压迫第Ⅷ颅神经有关，临床上应注意识别与诊断。

Objective . To investigate the clinical manifestations and imaging features of peripheral vestibular paroxysmia （PVP）. Methods The clinical data, including magnetic resonance tomographic angiography （ MRTA ） , of 7 PVP patients, 1 male and 2 females, aged 40 - 72, were retrospectively analyzed. Results （ 1 ） All 7 patients had non-specific cochleovestibular symptoms, e.g. , recurrent vertigo and continuous dizziness. （ 2 ） The predominant symptom was transient vertigo or dizziness with the sudden change of head position. （3） MRTA showed cross of the cochleovestibular nerve （CNV） and blood vessel in all patients. （4） Carbamazepine and sibelium succeeded to relieve the symptoms. Conclusion Compression of the cranial nerve Ⅷ by crossing vessel thereon may be the mechanism of PVP which can be identified and diagnosed clinically.