水平半规管良性阵发位置性眩晕的诊治

Diagnosis and treatment of horizontal canal benign paroxysmal positional vertigo

目的 探讨水平半规管良性阵发位置性眩晕 (horizontalcanalbenignparoxysmalpositionalvertigo ,HC BPPV)的诊治方法。方法 回顾分析 1996年 7月～ 2 0 0 0年 3月间南京医科大学第一附属医院耳鼻咽喉科诊治的 9例HC BPPV患者的临床资料。对所有患者全面采集病史 ,行纯音听阈测试和耳神经学检查 ,常规施行仰卧侧头位试验和Dix Hallpike试验 ,并按Barbecue翻滚法行耳石复位治疗。结果 本病以头位改变所诱发的短暂旋转性眩晕为特征 ,常见诱发体位为床上翻身 (9/ 9例 )和转头 (5 / 9例 )。仰卧侧头位试验可诱发水平向地性眼震 ,无潜伏期和疲劳性。采用Barbecue翻滚法治疗后全部患者症状立刻消失 ,随访 4～ 15个月无复发。结论 根据典型表现和体位试验结果 ,可明确区分水平半规管性和后半规管性BPPV以及其他原因引起的眩晕。Barbecue翻滚是治疗HC

Objective To explore effective methods for the diagnosis and treatment of horizontal canal benign paroxysmal positional vertigo (HC BPPV). Methods Medical records from nine patients with HC BPPV, treated between July 1996 and March 2000, were retrospectively analyzed. Data of complete history, audiograms, positional tests and neuro otological examinations were collected. All patients were treated with a particle repositioning maneuver called the “barbecue rotation” which starts with the patient in the supine position and consists of three 90 degree head rotations towards the unaffected ear. Results HC BPPV was characterized by brief attacks of intense vertigo that were induced mainly by rolling over in bed (9/9) and turning the head to either side while upright (5/9). In most cases, rotation to the pathological side from supine position caused a very intense horizontal nystagmus beating towards the undermost ear. Findings such as latency and fatigability, which are common features of posterior canal BPPV (PC BPPV), were not present. After the barbecue rotation, all patients had immediate and sustained relief of their attacks during the 4 to 15 months' follow up. ConclusionsHC BPPV is different from PC BPPV and other vertiginous diseases in typical presentations and positional testing results. The barbecue rotation is a successful method for curing the disorder.