Localizing signs in positional vertigo due to lateral canal cupulolithiasis
Localizing signs in positional vertigo due to lateral canal cupulolithiasis
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DOI：
10.1212/wnl.57.6.1085
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发表时间：
2001-09-25
期刊：
影响因子：
9.9
通讯作者：
Debatisse, D
中科院分区：
文献类型：
--
作者：
Bisdorff, AR;Debatisse, D
背景：良性位置性眩晕（BPV）已被确认为不同类型。仰卧位的永久性异向性、改变方向的外侧眼震变体尤其难以与中枢病因区分。目的：探讨该型BPV的临床特征，帮助确定其外周病因。方法：在5例无任何神经系统疾病证据的体位性眩晕患者中，研究眼球震颤的行为与头部空间位置的关系。结果：在仰卧位时，确定了一个外侧眼震的零点，超过这个零点，眼震就会改变方向。当头部向侧面转动10到20度时，这个零点是明显的。在这个位置，外侧半规管的同侧锥体与重力矢量对齐。在五名患者中，有两名患者在音高中发现了一个零点，超过这个零点，眼球震颤就会逆转方向。这个零点对应于侧管在地球水平面上的头部位置。结论：从不同体位下侧耳眼球震颤的表现来看，内耳侧耳道系统对重力敏感，可判断侧耳道受影响的部位。
Background: Different types of benign positional vertigo (BPV) have been recognized. The variant with permanent apogeotropic direction-changing lateral nystagmus in the supine position is particularly difficult to distinguish from central etiologies. Objective: To identify clinical features of this variant of BPV, helping to establish its peripheral etiology. Methods: In five patients without any evidence of neurologic disease and with this variant of positional vertigo, the behavior of nystagmus as a function of head position in space was studied. Results: In the supine position, a null point for lateral nystagmus was identified, beyond which the nystagmus changed direction. This null point was evident when the head was turned 10 to 20 degrees to the side. In this position, the ipsilateral cupula of the lateral semicircular canal is aligned with the gravity vector. In two of the five patients, a null point was identified in pitch, beyond which the nystagmus reversed direction. This null point corresponds to the head position where the lateral canals are in an earth horizontal plane. Conclusion: From the behavior of lateral nystagmus in different head positions, the lateral canal system of the inner ear is shown to be gravity-sensitive and the side on which the cupula is affected can be determined.