-
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.
-
Key words:
- vertigo /
- room tilt illusion /
- posterior circulation ischemic
-
-
[1] SIERRA-HIDALGO F,DE PABLO-FERNÁNDEZE,HERRERO-SAN MARTÍN A,et al.Clinical and imaging features of the room tilt illusion[J].J Neurol,2012,259:2555-2564.
[2] AKDAL G,TOYDEMIR H E,TANRIVERDIZADET,et al.Room tilt illusion:a symptom of both peripheral and central vestibular disorders[J].Acta Neurol Belg,2017,117:363-365.
[3] KIRSCH V,KEESER D,BECKER-BENSE S,et al.Vestibular and visual cortex activity during room tilt illusion[J].J Neurol,2017,264:70-73.
[4] CRUTCH S J,LEHMANN M,GORGORAPTIS N,et al.Abnormal visual phenomena in posterior cortical atrophy[J].Neurocase,2011,17:160-177.
[5] EIMIL-ORTIZ M,GONZÁLEZ-SALAICES M,HERAS I P,et al.Room tilt illusion in superior cerebellar artery stroke:Are we missing the classical neurological examination?[J].Neurol India,2012,60:423-424.
[6] MALIS D D,GUYOT J P.Room tilt illusion as a manifestation of peripheral vestibular disorders[J].Ann Otol Rhinol Laryngol,2003,112:600-605.
[7] LOPEZ DOMÍNGUEZ J M,ROJAS-MARCOS I,SANZ FERNÁNDEZ G,et al.Room tilt illusion:a rare symptom of migraine aura[J].Neurologia,2007,22:58-60.
[8] CRANE B T.Roll aftereffects:influence of tilt and inter-stimulus interval[J].Exp Brain Res,2012,223:89-98.
[9] HAYASHI R,YAMAGUCHI S,KATSUMATA Y,et al.Room tilt illusion in Parkinson's disease:loss of spatial reference frames?[J].J Neurol Sci,2009,287:264-266.
[10] ZHAO C,LU S,TAJOURI N,et al.Room tilt illusion influenced by head position[J].J Neuroophthalmol,2007,27:297-299.
[11] 王浩伟,郭英,周婧,等.后循环缺血性眩晕的视频眼震图表现[J].临床耳鼻咽喉头颈外科杂志,2018,32(2):99-102.
-
计量
- 文章访问数: 372
- PDF下载数: 714
- 施引文献: 0
下载: