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摘要: 目的:探讨房间倾斜错觉(RTI)主诉在耳科门诊中筛查中枢性眩晕的临床意义。方法:回顾性研究具有RTI主诉的8例患者,分析其症状、体征、诊断等病例特征。结果:①具有RTI主诉的患者占同期门诊头晕眩晕患者总数的1.2%。8例患者中,2例为急性前庭综合征,5例为发作性前庭综合征,1例无头晕和(或)眩晕发作。②2例确诊为急性小脑梗死,3例为后循环短暂性脑缺血发作,2例为明确的前庭性偏头痛,1例未明确病因。③8例患者均有发作性(单次或反复发作)、短暂性(数秒到数分钟)、发生在冠状面、角度为30~180°的环境倾斜感觉。④7例患者在短暂的RTI后出现持续数分钟到数小时的头晕或者眩晕症状,1例患者RTI结束后无其他症状发作。⑤所有患者均无vHIT增益下降,6例患者有眼动功能异常,1例患者有轻度外半规管轻瘫。结论:具有RTI主诉的患者主要为中枢性头晕眩晕疾病,耳科门诊一旦遇到需警惕中枢性疾病的可能。Abstract: Objective: This study aims to investigated the clinical significance of room tilt illusion(RTI) in screening for central vertigo in otology clinic. Method: A retrospective study of 8 RTI cases out of 656 patients with dizziness and/or vertigo. The characteristics of the symptoms, signs, physical examination, and other examinations of RTI patients were analyzed. Result: ①Patients with RTI complaints accounted for 1.2% of all patients with dizziness and/or vertigo in the same period. Of all 8 patients, 2 were with acute vestibular syndrome, 5 were with episodic vestibular syndrome, and one had no dizziness and/or vertigo attack. ②Two was diagnosed with acute cerebellar infarction, and 3 was diagnosed with posterior circulation transient ischemic attacks, 2 were diagnosed with definite vestibular migraine, and one was unable to identify the cause. ③All 8 patients had a sensation of environment tilting, which was episodic(single or repeated), transient(seconds to minutes), in the coronal plane, and with tilt angle 30-180°. ④Seven patients had dizziness and/or vertigo for minutes to hours after a transient RTI, and one patient had no other symptoms after RTI. ⑤All patients had no decrease in vHIT gain, 6 patients had abnormal oculomotor function, and one patient had mild horizontal semicircular canal paresis.Conclusion: Patients with RTI complaints mainly had central dizziness and vertigo diseases, and once are found in otology clinic, should be alert to the possibility of suffering from central diseases.
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Key words:
- vertigo /
- room tilt illusion /
- posterior circulation ischemic
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