良性阵发性位置性眩晕变位试验假阴性原因分析

马鑫; 司峰志; 刘燕; 韩琳; 静媛媛; 余力生

doi:10.13201/j.issn.1001-1781.2016.01.006

良性阵发性位置性眩晕变位试验假阴性原因分析

- 北京大学人民医院耳鼻咽喉科(北京, 100044)
基金项目:
“十二五”科技支撑计划(No:2012BAI12B02)

北京大学人民医院研究与发展基金(No:RDC2015-07)

详细信息

通讯作者: 余力生,E-mail:Yulish68@163.com

中图分类号: R764

收稿日期: 2015-10-20

The false-negative reasons of positioning test in benign paroxysmal positional vertigo

- Department of Otolaryngology, Peking University People's Hospital, Beijing, 100044, China

More Information

Corresponding author: YU Lisheng, E-mail: Yulish68@163.com

Received Date: 20 October 2015

摘要

摘要: 目的:分析良性阵发性位置性眩晕(BPPV)变位试验假阴性的比例和原因。方法:回顾性分析2009-02-2009-04期间就诊于北京大学人民医院耳鼻咽喉科门诊具有BPPV典型临床症状、变位试验确诊、经过复位治疗痊愈的68例BPPV患者的资料。所有患者均行变位试验检查,首次变位试验诱发出典型眼震者为阳性组;首次检查阴性的患者,摇头后或隔日复诊再次变位试验检查均获得典型眼震为假阴性组,经过复位治疗症状痊愈。结果:13例(19.12%)患者首次变位试验出现阴性,经过反复变位试验,出现阳性,其中11例在检查当天摇头后再次变位试验出现典型眼震者,2例隔日复诊变位试验出现典型眼震。假阴性组年龄、性别、病程、半规管类型与阳性组差异无统计学意义(P>0.05)。结论:对临床疑为BPPV但变位试验阴性的患者,建议摇头后再次检查并随访复查以获得典型眼震明确诊断。
- 良性阵发性位置性眩晕 /
- 摇头 /
- 眼震
Abstract: Objective:To analyze the false-negative proportion and reasons of positioning test in benign paroxysmal positional vertigo (BPPV).Method:Sixty-eight cases were reviewed and analyzed during February to April 2009. All patients had typical clinical history of BPPV and diagnosed by positioning test,and all were treated with PRM successfully. If positioning test at the first time were negative,examinations repeated after either head shaking or return visits.Result:Thirteen patients (19.12%) appeared false-negative in positoning test,and11cases showed typical nystagmus after head shaking,while 2 cases were diagnosed by return visitis the next day.There were no statistically difference between false-negative group and positive group in age (P>0.05), gender (P>0.05), course of disease (P>0.05) and types of semicircular canal (P>0.05).Conclusion:Re-examinations after head shaking or return visits are useful for the diagnosis in the suspected BPPV patients who have negative positioning test.
- benign paroxysmal positional vertigo /
- head shaking /
- nystagmus

HTML全文

参考文献(7)

[1]	中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科学分会.良性阵发性位置性眩晕的诊断依据和疗效评估(2006年,贵阳)[J].中华耳鼻咽喉头颈外科杂志,2007,42(3):163-164.
[2]	BHATTACHARYYA N,BAUGH R F.Clinical practice guideline:benign paroxysmal positional vertigo[J].Otolaryngol Head Neck Surg,2008,139:47-81.
[3]	马鑫,李蔷,余力生.病史两问法在良性阵发性位置性眩晕诊断中的意义[J].中国耳鼻咽喉头颈外科,2010,17(9):459-461.
[4]	WHITNEY S L,MARCHETTI G F,MORRIS L O.Usefulness of the dizziness handicap inventory in the screening for benign paroxysmal positional vertigo[J].Otol Neurotol,2005,26:1027-1033.
[5]	王武庆,孙琴,任同力.重复检查对诊断良性阵发性位置性眩晕的意义[J].中华医学杂志,2011,91(21):3254-3256.
[6]	KAPLAN D M,SLOVIK Y,JOSHUA B Z,et al.Head shaking during Dix-Hallpike exam increases the diagnostic yield of posterior semicircular canal BPPV[J].Otol Neurotol,2013,34:1444-1447.
[7]	CASANI A P,VANNUCCI G,FATTORI B,et al.The treatment of horizontal canal positional vertigo:our experience in 66cases[J].Laryngoscope,2002,112:172-178.