良性发作性位置性眩晕75例误诊分析

Analysis 75 Misdiagnosed Cases of Benign Paroxysmal Positional Vertigo

目的探讨良性发作性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床特征和误诊原因,提出防范误诊措施。方法回顾分析BPPV误诊75例的临床资料。结果 75例主要临床表现为改变头位时出现短暂性眩晕、呕吐及眼震。误诊为颈椎病41例,后循环缺血17例,躯体形式障碍7例,梅尼埃病6例,动脉硬化4例,误诊时间8 d^6年。经Roll试验及Dix-hallpike试验诊断为后半规管BPPV 59例,水平半规管BPPV 12例,混合型BPPV 4例;予Epley复位法及Barbecue翻滚法复位治疗1周治愈率达100%,3个月治愈率达93.3%。结论 BPPV临床表现缺乏特异性,易误诊,手法复位对BPPV效果显著。临床医生应加强对本病的认识,提高诊断水平及处理能力。

Objective To explore the clinical features and misdiagnosis cause of benign paroxysmal positional vertigo （BPPV） to propose methods to prevent misdiagnosis. Methods The clinical data of 75 cases were analyzed respectively. Results Among 75 misdiagnosed cases, 41 cases were misdiagnosed as cervical spondylosis, 17 as posterior circulation is-chemia, 6 as Meniere Disease, 7 as somatoform disorders, and 4 misdiagnosed as arteriosclerosis. Misdiagnosis time was from 8 d-6 years. The main clinical manifestations of BPPV were transient vertigo and nystagmus when the heads of the patients changed positions. Roll and Dix-hallpike tests showed that 59 cases were diagnosed as canalis semicircular is posterior, 12 as BPPV of horizontal semicircular canal and 4 as BPPV of mixed patterns. The cure rate of one-week treatment of Epley and Barbecue rolling repositioning was 100% and the cure rate of three months was 93. 3% . Conclusion The curative effect of manipulative reduction is noticeable for BPPV. Clinician must strengthen awareness of the disease in order to improve diagno-sis and treatment of BPPV.