Dix-Hallpike试验中眼震特点分析

Characteristics of Dix-Hallpike test induced nystagmus

目的:回顾分析100例Dix-Hallpike试验结果阳性眼震特点特别是伴垂直成分向下的眼震特点。方法:选取100例2017-12-2018-01期间行位置试验检查且Dix-Hallpike试验阳性患者,对Dix-Hallpike试验和滚转试验所诱发的眼震,记录其眼震最大慢相速度(SPV)、潜伏期和持续时间等基本参数,采用SPSS 22.0软件进行统计分析。结果:根据双侧Dix-Hallpike试验悬头位眼震方向和持续时间的不同,100例患者眼震可分为9种类型。以位置性眼震垂直成分分类,双侧或单侧只有垂直向上成分者56例,其中单侧逆(顺)时针伴垂直向上成分52例,双侧逆(顺)时针伴垂直向上成分4例;一侧垂直向上另一侧垂直向下者7例;双侧或单侧仅为垂直向下成分者47例。Dix-Hallpike试验悬头位出现伴垂直向上成分者为63%,出现伴垂直向下成分者为54%。此外,8例患侧出现反转向眼震,100例Dix-Hallpike试验阳性患者中有20例滚转试验呈阳性,5例出现水平眼震,15例出现扭转性伴垂直成分的眼震。结论:Dix-Hallpike试验诱发的眼震有多种类型,伴垂直成分向下的眼震较为常见,应综合分析,并需要进一步研究。

Objective：To retrospectively analyze the characteristics of 100 cases with Dix-Hallpike test induced nystagmus,especially the vertical downward component.Method：One hundred cases with positive Dix-Hallpike test between December 2017 and January 2018 were included in this study.Dix-Hallpike test and roll test were performed in all patients,and the max slow phase velocity（SPV）,latency and duration of positional nystagmus were analyzed with SPSS 22.0 software.Result：According to the difference in the direction and duration of the nystagmus in the head-hanging position on Dix-Hallpike test,100 patients were classified into 9 types.When only the vertical components were considered,56 cases presented with bilateral or unilateral vertical upward component,among which 52 cases had unilateral torsional with vertical upward component,4 cases had bilateral torsional with vertical upward component;7 cases presented with vertically upward in one side and the vertically downward in the other side;47 cases presented with bilateral or unilateral vertical downward component.In addition,8 cases showed the reverse phase nystagmus.Of the 100 patients with positive Dix-hallpike,20 cases were positive in roll test and 5 cases showing horizontal nystagmus and 15 cases showing torsional and vertical nystagmus.Conclusion：Vertical component in the positional nystagmus was common,and care should be taken to interpret the nystagmus into the underlying disorder.