Predicting a successful treatment in posterior canal benign paroxysmal positional vertigo
Predicting a successful treatment in posterior canal benign paroxysmal positional vertigo
复制标题
DOI：
10.1212/01.wnl.0000259037.76469.e4
复制
发表时间：
2007-04-10
期刊：
影响因子：
9.9
通讯作者：
Lim, Jeong Geun
中科院分区：
文献类型：
--
作者：
Oh, Hui Jong;Kim, Ji Soo;Lim, Jeong Geun
目的：目的：探讨Epley动作第二体位（Hallpike动作起始后对侧头转90度）定位性眼震的特点及预后价值。方法：对126例经手术证实的后半规管良性阵发性位置性眩晕（PC-BPPV）患者进行Epley手法治疗。用视频Frenzel眼镜研究了定位性眼球震颤的特征。结果如下：在第二个位置，99例患者发生扭转上跳性眼球震颤，这是在同一方向（正交性眼球震颤）在第一个位置（Hallpike动作），而15例患者表现出相反的模式。12例患者在第二体位时未诱发眼震。所有99例正交性眼球震颤患者在第一次或第二次Epley动作试验后BPPV均消退。相反，15例有反向眼震的患者中有12例和12例无眼震的患者中有8例未能消退。结论：在Epley手法的第二个位置，眼球震颤的正交模式预示着成功的复位，而反向眼球震颤或无眼球震颤提示复位反应不良。
Objective: To elucidate the characteristics and prognostic value of positioning nystagmus during the second position of the Epley maneuver (90 degrees contralateral head turn from the initial Hallpike maneuver). Method: The Epley maneuver was performed in 126 patients with confirmed posterior canal benign paroxysmal positional vertigo (PC-BPPV). The characteristics of positioning nystagmus were investigated using video Frenzel goggles. Results: During the second position, 99 patients developed torsional upbeating nystagmus, which was in the same direction (orthotropic nystagmus) as during the first position (Hallpike maneuver), whereas 15 patients showed a reversed pattern. In 12 patents, nystagmus was not induced during the second position. All 99 patients with orthotropic nystagmus had resolution of BPPV after the first or second trial of the Epley maneuver. In contrast, 12 of the 15 patients with reversed nystagmus and 8 of the 12 patients without nystagmus failed to resolve. Conclusion: During the second position of the Epley maneuver, an orthotropic pattern of nystagmus predicts a successful repositioning, whereas reversed nystagmus or no nystagmus is suggestive of poor response to repositioning.