眩晕症患者跌倒发作的病因分析

Causes of drop attacks in vertigo patients

目的分析眩晕症患者跌倒发作的病因,为临床诊疗提供借鉴。方法回顾性分析眩晕门诊10年内跌倒发作的眩晕症的病因分布,年龄趋势及就诊规律。结果眩晕症患者跌倒发作共35例,梅尼埃病耳石危象16例,无一在首次就诊时被问及;良性阵发性位置性眩晕跌倒发作7例;梅尼埃病与血管迷走神经性晕厥共患5例;继发于心源性晕厥后的BPPV 7例。随着年龄的增长,跌倒的发生率呈增长趋势。结论眩晕症患者跌倒发作的发生率被低估,病史采集不全是主要原因;难治性BPPV可能为晕厥后继发,诊疗过程需要关注患者心血管病史及相关检查;关注耳源性眩晕与晕厥的共患,进行及时正确的诊断与处理。

Objective To investigate the causes of drop attacks in vertigo patients to facilitate diagnosis and treatment.Methods Causes distribution, age trend and medical visits of dropping attacks in a vertigo clinic in the past 10years were retrospectively analyzed. Results Data from 35 cases of drop attacks in patients with vertigo were collected,including Meniere disease Tumarkin’s otolithic crisis (n = 16), whose drop attacks were not inquired at the initial visit,BPPV with drop attacks (n = 7), Meniere Disease with vasovagal syncope (n = 5), and BPPV secondary to cardiac syncope(n = 7). The incidence of drop attacks increased with age. Conclusion The incidence of dropping attacks in patientswith vertigo is underestimated. Incomplete history collection is the main reason. Intractable BPPV may be secondary tosyncope. More attention should be paid to history of cardiovascular diseases and relevant examinations during management.For timely correct diagnosis and treatment, it is very important to be aware of vertigo with syncope.