单侧后半规管BPPV患者Dix-Hallpike试验健侧诱发眼震阳性的临床特征

熊彬彬; 林春梅; 林烨丰; 刘劲; 陈钢钢

doi:10.13201/j.issn.1001-1781.2018.19.002

单侧后半规管BPPV患者Dix-Hallpike试验健侧诱发眼震阳性的临床特征

- 1. 暨南大学附属珠海医院(珠海市人民医院)耳鼻咽喉头颈外科(广东珠海, 519000);
- 2. 山西医科大学第一医院耳鼻咽喉头颈外科耳鼻咽喉头颈肿瘤山西省重点实验室山西医科大学耳鼻咽喉研究所
基金项目:
珠海市科技计划项目 (No:20171009E030055)

详细信息

通讯作者: 陈钢钢, E-mail:chenganggang@vip.163.com

中图分类号: R764.3

收稿日期: 2018-08-03

The clinical characteristics of the evoked nystagmus in the non-affected side during Dix-Hallpike test in the unilateral posterior semicircular canal benign paroxysmal positional vertigo

- 1 Department of Otolaryngology Head and Neck Surgery, Zhuhai Hospital Affiliated with Ji'nan University, (Zhuhai People's Hospital), Zhuhai, 519000, China;
- 2 Department of Otolaryngology Head and Neck Surgery, the First Hospital, Shanxi Medical University, Shanxi Key Laboratory of Otorhinolaryngology Head and Neck Cancer, Key Institute and Laboratory of Otolaryngology Affiliated with Shanxi Province

More Information

Corresponding author: CHEN Ganggang, E-mail: chenganggang@vip.163.com

Received Date: 03 August 2018

摘要

摘要: 目的: 探讨单侧后半规管良性阵发性位置性眩晕(PC-BPPV)Dix-Hallpike试验(简称D-H试验)健侧诱发眼震阳性的临床特征。方法: 回顾性分析236例PC-BPPV患者中14例D-H试验健侧诱发眼震阳性患者的临床资料。结果: D-H试验患侧均可诱发上跳性向地扭转型眼震,其中右PC-BPPV 11例,左PC-BPPV 3例;健侧诱发患侧同型上跳性扭转型眼震5例,其中右PC-BPPV 4例,左PC-BPPV 1例;健侧诱发垂直下跳性眼震9例,其中右PC-BPPV 7例,左PC-BPPV 2例。采用患侧Epley或Semont复位,眼震和眩晕均完全消失。结论: 单侧PC-BPPV D-H试验同样可以诱发双侧阳性,非患侧诱发眼震的类型与耳石在后半规管的初始位置和其在诱发试验过程中流动方向有关。行患侧Epley或Semont手法复位有效,其复位效果和D-H试验诱发的眼震类型可以交互验证患侧别。
- 眼震 /
- 眩晕 /
- Dix-Hallpike试验
Abstract: Objective: To investigate the clinical characteristics of the evoked nystagmus in the non-affected side during Dix-Hallpike test(D-H test)in unilateral posterior semicircular canal benign paroxysmal positional vertigo(PC-BPPV). Method: Two hundred and thirty-six patients were diagnosed with unilateral PC-BPPV in the Tinnitus and Dizziness clinic. Among them, 14 patients exhibited positive nystagmus when the non-affected side was stimulated by D-H test. The clinical data from this subgroup of patients were retrospectively analyzed. Result: The upbeat and torsional nystagmus of 14 patients were all evoked by D-H test in the affected side. 11 cases were right PC-BPPV and 3 cases were left PC-BPPV. Among these 14 patients, 5 patients exhibited the upbeat and torsional nystagmus during D-H test in the non-affected side, which was in the same direction as that evoked in the affected side. Among them, 4 cases were right PC-BPPV and 1 case was left PC-BPPV. However, the downbeat nystagmus of the remaining 9 patients were evoked by D-H test in the non-affected side, in which 7 cases were right PC-BPPV and 2 cases were left PC-BPPV.The nystagmus and vertigo of all patients completely disappeared after performing the Epley or Semont repositioning maneuvers on the affected side. Conclusion: The bilateral positive nystagmus of unilateral PC-BPPV can be evoked by D-H test. The form of nystagmus on the non-affected side is related with the initial position of otoconia in affected semicircular canal and the moving direction of otoconia during the positional test. It is effective to perform Epley or Semont repositioning maneuvers on the affected side. Meanwhile, both the effect of maneuvers and the type of nystagmus evoked by D-H test can verify which side is affected.
- positive nystagmus /
- vertigo /
- Dix-Hallpike

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