首次Roll试验表现为双侧定向性水平眼震的外半规管BPPV患者的临床特征分析

Clinical characteristics of LC-BPPV patients with bilateral direction-fixed horizontal nystagmus in primary Roll test

目的:探讨首次Roll试验时表现为定向水平眼震的外半规管良性阵发性位置性眩晕(LC-BPPV)的临床特征。方法:首次Roll试验表现为双侧定向水平眼震的LC-BPPV患者9例,判断患侧后进行手法复位治疗,观察预后。结果:8例患者离地眼震侧为患侧,使用Barbecue法或Gufoni法复位有效;另1例患者眼震未发生转换,无法判断患侧。结论:LC-BPPV患者行Roll试验时眼震表现复杂,需仔细分析各体位眼震表现,结合低头-仰头试验、坐位-仰卧位试验、零平面等综合判断,推测耳石所在位置,并综合运用Barbecue法、Gufoni法、患侧强迫体位、乳突叩击、坐位摇头等手法完成复位治疗。

Objective:To investigate the clinical features of LC-BPPV with direction-fixed horizontal nystagmus in the primary Roll test.Method:Nine patients of LC-BPPV with bilateral direction-fixed horizontal nystagmus in the first Roll test were treated by repositioning maneuvers after judging the affected side and the prognosis was observed.Result:The affected side of eight patients was the side of the apogeotropic nystagmus.Barbecue or Gufoni maneuvers was effective for reposition.The other one had no conversion of nystagmus and could not judge the affected side.Conclusion:The nystagmus performance of patients with LC-BPPV is complicated.It is necessary to carefully analyze the nystagmus performance of each position.Combining with bow and lean test,lying down test and null plane,the position of the otolith is inferred.Comprehensive use of the Barbecue or Gufoni maneuvers,forced side lying on the affected side,mastoid sniper,shaking head method is effective to complete the reposition treatment.