良性陣發性位置性眩暈107例患者臨床分析

Analysis of 107cases with benign paroxysmal positional vertigo

目的探討良性陣發性位置性眩暈(Benign paroxysmal positional vertigo BPPV)的診斷和治療效果。方法回顧性分析107例診斷BPPV患者的病程發作類型、發病後首診科室、最初診斷、確診前就診次數、復位次數及復發情况。結果107例BPPV患者中,男32例、女75例,年齡22歲~88歲,病程半天至45天。其中後半規管101例(94.4%);水平半規管4例(3.7%),混合型2例(1.9%)。手法復位效果好,一次成功者85例(79.4%),隨訪期間復發13例。第一次診治確診60例,未能確診47例。確診前曾做過的檢查有頭顱CT6例、頭顱MRI9例、頸椎X光1例、頸椎MRI2例。結論BPPV是一種常見的周圍性眩暈疾病,進行誘發測試及手法復位治療有助診斷及治療。提高醫生對BP PV的認識,及時轉介至相關醫生,患者可及時得到診治及減少不必要檢查。

Objective To explore the diagnosis and treatment method for benign paroxysmal positional vertigo(BPPV).Methods 107cases diagnosed BPPV were retrospectively analyzed for duration of vertigo,department for first consultation,first diagnosis,times lapsed before arriving at correct diagnosis,times of canalith repositioning procedure(CRP)and recurrence rate.Results 32 males and 75 females with age of 22-88 years old.Posterior semicircular canal was involved in 101 cases(94.4%)whereas the horizontal semicircular and multiple canals are 4 cases(3.7%)and 2 cases(1.9%)respectively.Eighty-five cases(79.4%)recovered completely on the first visit.Examinations including brain CT(6 cases),brain MRI(9 cases),cervical spine x-ray(1 case)and cervical spine MRI(2 cases)were performed before diagnosis.Conclusion BPPV is a common cause of peripheral vertigo disease.The Dix-Hallpike Maneuver or Roll test can help to make diagnosis and CRP remains an efficient treatment for BPPV.Having better knowledge of BVVP and early referral might help to rapidly relief the symptom and reduce the time of visits and unnecessary examinations.