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| 良性阵发性位置性眩晕复位后残余症状持续时间和病因分析 |
| 李斐1,肖本杰2,陈瑛1,高博1,严静宇1,赵菲1,周晓闻1,顾欢欢1,庄建华1* |
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(1. 第二军医大学长征医院神经内科, 上海 200003;
2. 上海市第一人民医院分院神经内科, 上海 200081
*通信作者) |
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| 摘要: |
| 目的 探讨良性阵发性位置性眩晕复位成功后残余症状的持续时间及可能病因。方法 纳入2016年10月至2017年1月就诊于第二军医大学长征医院神经内科的原发性良性阵发性置性眩晕且复位成功的60例患者，对其中存在残余症状患者的视觉模拟量表（VAS）评分、医院焦虑抑郁量表（HADS）评分、主观视觉垂直线（SVV）和眼肌前庭诱发肌源性电位（oVEMP）进行记录，随访并记录残余症状持续时间。按残余症状持续时间将患者分为短时组（残余症状持续时间≤ 7 d）和长时组（残余症状持续时间>7 d），比较2组患者上述临床指标的差异。结果 复位成功后存在残余症状的患者有36例（60.00%），其中22例（61.11%）患者在1周内自发缓解，14例残余症状持续时间超过1周。短时组患者复位后当日的VAS评分和HADS评分均低于长时组（P均<0.05），SVV反方向偏斜发生率高于长时组[63.6%（14/22）vs 28.6%（4/14），χ2=4.21，P=0.04]，而2组的oVEMP异常率差异无统计学意义。结论 复位成功后短暂的耳石器功能障碍和中枢再调定延迟参与了BPPV残余症状的发生，但其主观头晕症状较轻、持续时间较短。持续时间超过1周的残余症状多与精神情绪因素相关。 |
| 关键词: 良性阵发性位置性眩晕 残余症状 持续时间 前庭肌源诱发电位 |
| DOI：10.16781/j.0258-879x.2018.02.0216 |
| 投稿时间：2017-09-11修订日期：2017-11-24 |
| 基金项目: |
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| Cause analysis and duration of residual dizziness after successful canalith repositioning maneuver in patients with benign paroxysmal positional vertigo |
| LI Fei1,XIAO Ben-jie2,CHEN Ying1,GAO Bo1,YAN Jing-yu1,ZHAO Fei1,ZHOU Xiao-wen1,GU Huan-huan1,ZHUANG Jian-hua1* |
(1. Department of Neurology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China;
2. Department of Neurology, Branch of Shanghai General Hospital of, Shanghai 200081, China
*Corresponding author) |
| Abstract: |
| Objective To explore the duration of residual dizziness after successful canalith repositioning maneuvers in patients with benign paroxysmal positional vertigo (BPPV) and the possible causes. Methods A total of 60 BPPV patients with successful canalith repositioning maneuver were recruited from Department of Neurology of Changzheng Hospital of Second Military Medical University from Oct. 2016 to Jan. 2017. Visual Analogue Scale (VAS), Hospital Anxeity and Depression Scale (HADS), subjective visual vertical (SVV) and ocular vestibular evoked myogenic potential (oVEMP) were evaluated in the BPPV patients suffering from residual dizziness after successful canalith repositioning maneuvers, and their residual dizziness duration was recorded. According to the residual dizziness duration, the patients were divided into short-term group (≤ 7 d) and long-term group (>7 d), and the difference of clinical characteristics was analyzed. Results There were 36 (60.00%) BPPV patients with residual dizziness after successful canalith repositioning maneuver, and 22 (61.11%) cases recovered within 1 week, and 14 lasted for more than 1 week. Compared with the long-term group, VAS and HADS scores were significantly lower (all P<0.05) and reverse deviation incidence of SVV were higher in the short-term group (63.6%[14/22] vs 28.6%[4/14], χ2=4.21, P=0.04). There was no significant difference in oVEMP abnormality rate between the two groups. Conclusion The transient otolithic dysfunction and central readaption play a role in the occurrence of residual dizziness of the BPPV patients after successful canalith repositioning maneuver, and the residual dizziness usually has mild symptoms and a shorter duration. The residual dizziness with a duration longer than 7 days is associated with mental and emotional factors. |
| Key words: benign paroxysmal positional vertigo residual dizziness duration vestibular evoked myogenic potential |
