PDF(Pubmed)
Abstract：
Introduction: Benign paroxysmal positional vertigo (BPPV) stands as the most common cause of peripheral vertigo. Its treatment with repositioning maneuvers on an examination table is highly effective. However, patients with back or neck problems, paraplegia, or other conditions face challenges with these maneuvers, potentially experiencing longer healing times and creating additional difficulties for physicians diagnosing and treating BPPV in everyday practice. The emergence of mechanical rotational chairs (MRCs) offers a more convenient alternative for performing these maneuvers. Objectives: The primary objective was to compare the effectiveness of maneuvers on the examination table with those on MRCs in BPPV patients diagnosed in the emergency room and randomly classified into one of the treatment options. The secondary objectives included a comparison of patient quality of life during BPPV episodes and after their resolution and an analysis of recurrences and associated risk factors. Methods: This was a cohort study on sixty-three patients diagnosed with BPPV in the emergency department. Patients were classified into two cohorts depending on diagnostic and treatment maneuvers (MRC or conventional repositioning maneuvers (CRMs)) and received weekly follow-ups until positioning maneuvers became negative. Subsequent follow-ups were conducted at 1 month, 3 months, and 6 months after the resolution of vertigo. Patients were classified into two groups based on their assigned treatment method. Results: Thirty-one patients were treated with CRMs and 32 with TRV. Mean age was 62.29 ± 17.67 years and the most affected canal was the PSC (96.8%). The mean number of required maneuvers was two, while 55.56% only required one maneuver until resolution. Recurrence was present in 26.98% of the patients during the 6-month follow-up. Comparing both cohorts, there were no statistically significant differences between treatments (TRV vs. CRM) regarding the number of maneuvers, number of recurrences, and days until remission of BPPV. Dizziness Handicap Inventory and Visual Analogue Scale values decreased considerably after BPPV resolution, with no statistically significant differences between the groups. Age was identified as a covariable in the number of maneuvers and days until BPPV resolution, showing that an increase in age implies a greater need of maneuvers. Conclusions: There was no difference between the means of treatment for BPPV in our population ot There was no difference between the groups of treatments for BPPV in our population. The quality of life of patients improved six months after the resolution of BPPV, regardless of the treatment applied.
摘要：
简介：良性阵发性位置性眩晕（BPPV）是周围性眩晕的最常见原因。在检查台上进行重新定位操作的治疗非常有效。然而,有背部或颈部问题的患者，截瘫,或其他条件面临这些演习的挑战，可能会经历更长的愈合时间，并在日常实践中为医生诊断和治疗BPPV带来额外的困难。机械旋转椅（MRC）的出现为执行这些操作提供了更方便的替代方案。目标：主要目的是比较在急诊室诊断并随机分为治疗方案之一的BPPV患者的检查台上与MRC上的操作的有效性。次要目标包括比较BPPV发作期间和消退后的患者生活质量，并分析复发和相关风险因素。方法：对63例急诊诊断为BPPV的患者进行队列研究。根据诊断和治疗操作（MRC或常规重新定位操作（CRM））将患者分为两组，并每周接受随访，直到定位操作变为阴性。随后随访1个月，3个月,眩晕消退后6个月。根据指定的治疗方法将患者分为两组。结果：31例患者接受了CRM治疗，32例接受了TRV治疗。平均年龄为62.29±17.67岁，受影响最大的管道是PSC（96.8％）。所需机动的平均次数是两次，而55.56%只需要一个机动直到解决。在6个月的随访中，有26.98％的患者出现复发。比较两个队列，治疗之间没有统计学上的显著差异(TRV与CRM)关于机动次数，复发次数，直到BPPV缓解。头晕障碍清单和视觉模拟度值在BPPV分辨率后大幅下降，组间无统计学差异。年龄被确定为演习次数和天数的协变量，直到BPPV解决，表明年龄的增加意味着更需要机动。结论：在我们的人群中，BPPV的治疗手段之间没有差异。在我们的人群中，BPPV的治疗组之间没有差异。BPPV消退后6个月，患者的生活质量有所改善，无论采用何种治疗。
