Posturographic performance in patients with the potential for secondary gain
Posturographic performance in patients with the potential for secondary gain
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DOI：
10.1016/s0194-5998(00)70137-9
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发表时间：
2000-01-01
影响因子：
3.4
通讯作者：
Belafsky, P
中科院分区：
文献类型：
--
作者：
Gianoli, G;McWilliams, S;Belafsky, P
目的：确定计算机动态姿势描记（CDP）中非器质性摇摆模式在潜在继发性增益患者与无任何明显继发性增益患者中的发生率。对100例接受临床评价、听力测定、眼震电图和CDP的患者进行了回顾性图表审查，第1组包括50例随机选自未决诉讼组的患者，工人的赔偿要求，或残疾索赔。第2组由50名随机选择的患者组成，他们没有未决的法律的地位，工人的赔偿要求，或残疾索赔，以前发表的非器质性摇摆模式的标准，然后应用于每组。结果：第1组患者的平均年龄为43.8岁，第2组患者的平均年龄为63.2岁（P < 0.0001）。在第1组患者中，50%的患者具有正常的听前庭评估，而第2组患者中只有4%具有正常的听前庭评估（P < 0.0001）。第1组患者中76%的患者出现非器质性摇摆模式，而第2组患者中仅8%出现非器质性摇摆模式（P < 0.0001）。结论：具有继发性增益潜力的患者通常更年轻，且在CDP上正常听前庭评估和非器质性摇摆模式的患病率更高。在评估有未决诉讼的头晕患者时，应保持高度的临床怀疑。
OBJECTIVES: To determine the incidence of nonorganic sway patterns on computerized dynamic posturography (CDP) among patients with potential secondary gain compared with patients without any obvious secondary gain.METHODS: A retrospective chart review of 100 patients who underwent clinical evaluation, audiometry, electronystagmography, and CDP was undertaken, Group 1 consisted of 50 patients who were randomly selected from a group who had pending lawsuits, worker's compensation claims, or disability claims. Group 2 consisted of 50 randomly selected patients who had no pending legal status, worker's compensation claims, or disability claims, Previously published criteria for nonorganic sway patterns were then applied to each group. Statistical analysis was performed.RESULTS: The average age of group 1 patients was 43.8 years compared with 63.2 years for group 2 patients (P < 0.0001). Among group 1 patients 50% had normal audiovestibular evaluations compared with only 4% of group 2 patients (P < 0.0001). Nonorganic sway patterns were found in 76% of group 1 patients, but only in 8% of group 2 patients (P < 0.0001).CONCLUSION: Patients who have the potential for secondary gain are generally younger and have a much higher prevalence of normal audiovestibular evaluations and a much higher prevalence of nonorganic sway patterns on CDP. A high degree of clinical suspicion should be maintained when evaluating the dizzy patient who has a pending lawsuit.