水平半规管轻嵴帽眼震特征分析

Nystagmus characteristics of the horizontal semicircular canal light cupula

目的:探讨9例水平半规管轻嵴帽患者的位置性眼震特征。方法:选取2017-09-2017-12期间就诊于上海交通大学附属第六人民医院耳鼻咽喉科门诊,有典型体位性眩晕病史而位置试验表现为水平向地性变向性位置性眼震并持续时间>1min的患者。行翻滚试验诱发眼震,通过视频眼震电图分析记录患者的眼震特征,包括潜伏期、眼震时长、眼震强度等。以Barbecue方法试行复位治疗,未再行其他方法治疗。结果:纳入患者9例,Dix-Hallpike试验无眼震,滚转试验出现持续性向地性位置性眼震,记录到的眼震平均持续时间(64.2±13.7)s,平均潜伏期(5.3±4.7)s,部分患者有渐强-渐弱的趋势。以Barbecue方法试行复位治疗,即刻疗效为0,1周内痊愈者4例,1周内好转且2周内痊愈者2例,1例患者转变为后半规管BPPV,2例未进行门诊随访。结论:轻嵴帽的位置性眼震可有数秒的潜伏期,部分患者眼震强度有渐强-渐弱的趋势。Barbecue治疗效果不佳,但预后良好。

Objective：To analyze the nystagmus characteristics of 9 patients with horizontal semicircular canal light cupula.Method：Patients who visited the department of otolaryngology of Shanghai sixth people＇s hospital from September 2017 to December 2017 with a typical history of positional vertigo and roll test evoked horizontal geotropic direction changing nystagmus that lasted more than one minute were enrolled in the study.Nystagmus was monitored using the videonystagmoscopy（VNG）,and parameters of nystagmus,including latency,duration and the intensity of nystagmus were analyzed.Barbecue maneuvers were tried for all patients and no other treatment was performed.Result：Nine patients were enrolled,Dix-Hallpike test had no nystagmus,Roll test showed a persistent geotropic DCPN,the recorded average duration of nystagmus was（64.2±13.7）s（longer actually）,and averaged latency was（5.3±4.7）s.In some cases,positional nystagmus increased rapidly in intensity and then declined slowly as seen in patients with canalolithiasis.Immediate effectiveness is 0 after barbecue maneuver,but4 patients recovered within one week,2 patients improved within 1 week,and recovered within 2 weeks,1 patient transferred into posterior semicircular canal BPPV,and 2 cases had not been followed up.Conclusion：Nystagmus of horizontal canal light cupula has a latency of several seconds,with a crescendo-decrescendo pattern of intensity.Barbecue maneuver may be not effective in resolving nystagmus,but the prognosis is good for those patients.