168例眩晕患者临床特征分析

Clinical features of 168 patients with vertigo

目的:探讨眩晕患者的常见病因及临床特点。方法:询问168例眩晕患者的病史,并行纯音测听、红外视频眼震电图、Dix-Hallpike试验、颈椎X摄片、头颅CT和(或)MRI以及多普勒超声等检查,对相关结果进行统计学分析。结果:所有患者中周围性眩晕134例(79.8%),其中良性阵发性位置性眩晕(BPPV)66例,梅尼埃病30例,突发性聋24例,前庭神经炎5例,中耳炎并迷路炎5例,耳带状疱疹2例,耳毒性药物中毒2例;前庭中枢性眩晕26例(15.5%),其中椎基底动脉短暂性脑缺血(包括颈椎病)20例,听神经瘤2例,脑梗死3例,抑郁症1例;原因不明8例(4.8%)。结论:眩晕患者以周围性眩晕多见,其中BPPV发病率最高,详细采集病史和分析眩晕发作的特点,尤其是眩晕持续时间及听力变化是鉴别、诊断眩晕疾病的重要依据。

Objective：To investigate the clinicial characteristics and common etiology of vertigo.Method：The clinical data of 168patients with vertigo in the department of otolaryngolology and neurology from December 2007 to March 2009were retrospectively analyzed The patients were inquired and examined by pure tone average thresholds,videonystagmography,Dix-Hallpike test,cervical spine X-ray,skull CT and （or）MRI and transcranial Doppler.Result：One hundred and thirty-four patients with vertigo were of peripheral origin,with 66cases benign paroxysmal positional vertigo,30cases Meniere＇s disease,24cases sudden deafness,5cases vestibular neuritis,5 cases otitis media,2cases ear herpes zosters and 2cases ototoxicity.Among 26patients with vertigo of central,20patients were vertebrobasilar TIA.Conclusion：The most common etiology of the vestibular peripheral vertigo is the benign paroxysmal positional vertigo.Detailed history and the features of vertigo,particular about the duration of vertigo and hearing change,may provide the important evidences for the accurate diagnosis and differential diagnosis of vertigo.