眼震视图对水平管良性阵发性位置性眩晕与偏头痛性眩晕的鉴别诊断价值

Detection of videonystagmography in diagnosis of patients with BPPV and patients with MV

目的探讨眼震视图对水平管良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)与偏头痛性眩晕(migrainous vertigo,MV)的鉴别诊断价值。方法回顾性分析26例水平管BPPV患者与27例MV患者的临床资料,均在急性期或亚急性期通过眼震视图行中枢性眼动、冷热试验、变位试验检查,头颅颈部影像学检查排除其他疾病,对二者的前庭功能检查结果进行比较分析。结果 MV组和水平管BPPV组变位试验中多个体位的眼震在潜伏期、持续时间和慢向速度方面均有统计学差异,MV组中枢性异常眼动如扫视眼震(25.9%vs 0)、凝视眼震(37.0%vs 3.8%)、视动眼震(40.7%vs 3.8%)、平稳跟踪试验(18.5%vs 0)异常发生率及温度试验结果异常发生率明显高于水平管BPPV组,差异有统计学意义(P<0.05)。结论在结合病史及临床表现的基础上,眼震视图对水平管BPPV和MV急性发作期的鉴别诊断有重要价值。

Objective To study the clinical application of videonystagmography in the diagnosis of the patients with BPPV and patients with MV. Methods Clinical data of 26 patients with BPPV and 27 patients with MV treated at a specialty vertigo clinic and ward were retrospectively analyzed. All patients underwent videonystagmography,caloric test and positional test. The results of the vestibular function tests were compared and analyzed. Results The 53 patients included 19 men and 34 women,aged 34-82 years. There was significant difference in Roll test between the two groups,including latency period,slow velocity and duration. The patients presented an higher incidence in central nystagmus in MV. The incidience of bilateral vestibular function impairment in the patients with BPPV was lower than those with MV. Conclusions With the clinical feature and disease history,the videonystagmography play an important role in the diagnosis for the patients with BPPV and MV.