[A method for prediction functional dizziness after benign paroxysmal positional vertigo].
[A method for prediction functional dizziness after benign paroxysmal positional vertigo].
复制标题
良性阵发性位置性眩晕后功能性头晕的预测方法
DOI：
10.17116/jnevro2021121051120
复制
发表时间：
2021
影响因子：
--
通讯作者：
S. Olimpieva
中科院分区：
文献类型：
--
作者：
G. M. Dyukova;A. Kryukov;S. A. Makarov;A. L. Guseva;S. Olimpieva
客观化
目的：通过对良性阵发性位置性眩晕(BPPV)患者发病时情绪和人格障碍的分析，找出BPPV患者功能性眩晕(FV)的危险因素，并建立一种预测其发展的方法。
材料和方法
这项研究包括93名患有良性阵发性位置性眩晕(BPPV)的人，81名女性(87.1%)，年龄18至65岁，平均年龄50[41.5；59]。复位手法治疗成功后，1个月后复查。53名患者接受了半结构化访谈，以确定恐慌症发作(PA)的病史，使用DSM-5诊断标准。BPPV治疗成功后，患者完成以下量表和问卷：头晕残疾问卷(DHI)、眩晕症状量表(VSS-SF)、恐惧数字模拟量表(从0到10)、去人格化-去个人化问卷(DDI)、PHQ-9、GAD-7、PHQ-15、Holmes-Rahe应激量表、焦虑敏感指数(ASI)。
结果
根据BPPV术后1个月有无头晕主诉(第1组，n=17)和无主诉(第2组，n=76)，队列分为两组。PA病史第1组高于第2组(80vs29.3%)。第1组患者各量表得分均较高：DHI(57 vs 49，p=0.048)、DHI-E(18 vs 12，p=0.006)、A VSS-SF(9 vs 5，p=0.03)、DDI(18 vs 11，p=0.01)、GAD-7(13 vs 4，p=0.0002)、数字模拟恐惧(10 vs 5，p<；0.00005)、ASI(55.5vs 36.5，p<；0.005)。建立了BPPV后FD的预测方法，其敏感性为78.9%(95%CI为67.80~86.94)，特异性为94.12%(95%CI为71.31~99.85)。
结论
使用所提出的预测方法可以预测BPPV后发生FV的可能性。早期筛查FV可用于预防持续性的体位性-知觉性眩晕。
OBJECTIVE
To identify risk factors for functional vertigo (FV) in patients with benign paroxysmal positional vertigo (BPPV) based on the analysis of emotional and personality disorders at the time of the occurrence of BPPV and to develop a method for predicting its development.
MATERIAL AND METHODS
The study included 93 people, 81 women (87.1%), with benign paroxysmal positional vertigo (BPPV), aged 18 to 65 years, mean age 50 [41.5; 59]). After successful treatment with repositioning maneuvers, patients were re-examined 1 month later. Fifty-three patients underwent a semi-structured interview to identify a history of panic attacks (PA) using DSM-5 diagnostic criteria. After successful BPPV treatment, patients completed the following scales and questionnaires: Dizziness Handicap Inventory (DHI), Vertigo Symptom Scale Short form (VSS-SF), Numeric analog scale of fear (from 0 to 10), Depersonalization-Derealization Inventory (DDI), PHQ-9, GAD-7, PHQ-15, Holmes-Rahe Stress Inventory, Anxiety Sensitivity Index (ASI).
RESULTS
The cohort was divided into two groups according to the presence (group 1, n=17) or absence (group 2, n=76) of complaints for dizziness 1 month after BPPV. The frequency of PA history in group 1 was higher than in group 2 (80 vs 29.3%). Patients from group 1 had higher rates in all scales: DHI (57 vs 49, p=0.048), subscale DHI-E (18 vs 12, p=0.006), and subscale A VSS-SF (9 vs 5, p=0.03); DDI (18 vs 11, p=0.01), GAD-7 (13 vs 4), p=0.0002), Numeric analog scale of fear (10 vs 5, p<0.00005), ASI (55.5 vs 36.5, p<0.005). We developed a predictive method for diagnosis FD after BPPV, which sensitivity is 78.9% (95% CI 67.80-86.94) and specificity 94.12% (95% CI 71.31-99.85).
CONCLUSION
The likelihood of developing FV after BPPV can be predicted using the proposed predictive method. Early screening for FV can be used to prevent persistent postural-perceptual dizziness.