轻嵴帽:解释持续向地性变向性位置性眼震的新理论

Light cupula: A new theory in explanation of persistent geotropic direction-changing positional nystagmus

近年来临床上发现一类特殊性眼震表现为持续向地性变向性位置性眼震(direction-changing positional nys-tagmus,DCPN),没有潜伏期和疲劳性,患侧头位偏转时出现零平面。不同于水平半规管良性阵发性位置性眩晕的短暂性向地性DCPN,而与持续背地性DCPN发生机制相反,轻嵴帽理论被用来解释这一具特征性的眼震。本文对轻嵴帽及其DCPN特征、可能病因、发生机制假说、治疗与预后、及与BPPV的相关性等进行综述。

In recent years, a unique direction-changing positional nystagmus (DCPN), with no latency or fatigabilitybut a null point when head is turned toward the affected side, has been described. Different from the transient geotropicDCPN seen in BPPV from horizontal semicircular canal, it is just the reverse of the pathogenic mechanism of persistent apogeotropicDCPN. Light cupulae theory has been used to explain the characteristics of this unique nystagmus. In this paper,the light cupulae, characteristics of DCPN, possible etiologies, pathogenesis hypotheses, treatment and prognosis, and thecorrelation between DCPN and BPPV are reviewed.