PDF(Pubmed)
Abstract：
UNASSIGNED: This study aimed to investigate the characteristics of positional nystagmus in patients with cupulolithiasis of the posterior semicircular canal-benign paroxysmal positional vertigo (PC-BPPV-cu) to improve clinical diagnostic accuracy.
UNASSIGNED: This study retrospectively analyzed 128 cases of PC-BPPV-cu and 128 cases of canalolithiasis of BPPV (PC-BPPV-ca). General data, intensity, distribution, and the correlation of positional nystagmus were compared between the two groups.
UNASSIGNED: Compared to the PC-BPPV-ca group, more cases from the PC-BPPV-cu group initially presented in the emergency department (P < 0.05). The most frequent positional nystagmus induced by PC-BPPV-cu was torsional-upbeat nystagmus, characterized by the upper pole of the affected eye beating toward the lower ear and vertically upward (387 cases, 59.7%). It was followed by torsional-downbeat nystagmus, characterized by the upper pole of the unaffected eye beating toward the lower ear and vertically downward (164 cases, 25.3%). The former represented posterior canal excitatory nystagmus (PC-EN), while the latter represented posterior canal inhibitory nystagmus (PC-IN). In the PC-BPPV-cu group, PC-EN was most easily caused by the Half Dix-Hallpike (HH) maneuver on the affected side, while PC-IN was most easily induced by a face-down position (FDP) on the unaffected side at approximately 45° angle (45° FDP). The vertical slow phase velocity (v-SPV) of positional nystagmus was more potent in the affected HH than in other positions with PC-EN (all P < 0.05); the v-SPV of positional nystagmus was greater in the 45° FDP than in different positions with PC-IN (all P < 0.05); the v-SPV of the affected Dix-Hallpike (DH) maneuver in the PC-BPPV-ca group was significantly greater than that of the affected HH maneuver in the PC-BPPV-cu group (P < 0.05). The a priori analysis showed that the strongest correlation with HH positional nystagmus was observed in the affected side roll test, followed by the DH maneuver.
UNASSIGNED: In the PC-BPPV-cu group, the HH maneuver most easily induced PC-EN on the affected side, and PC-IN was most easily induced by the 45° FDP. In some cases of PC-BPPV-cu, significant nystagmus was not observed to be induced in the DH position on the affected side; however, vertical rotation nystagmus was induced in the roll-test position on the affected side. In such cases, PC-BPPV-cu diagnosis should be considered, and HH and 45° FDP tests should be conducted to support the diagnosis.
UNASSIGNED: This study retrospectively analyzed 128 cases of PC-BPPV-cu and 128 cases of canalolithiasis of BPPV (PC-BPPV-ca). General data, intensity, distribution, and the correlation of positional nystagmus were compared between the two groups.
UNASSIGNED: Compared to the PC-BPPV-ca group, more cases from the PC-BPPV-cu group initially presented in the emergency department (P < 0.05). The most frequent positional nystagmus induced by PC-BPPV-cu was torsional-upbeat nystagmus, characterized by the upper pole of the affected eye beating toward the lower ear and vertically upward (387 cases, 59.7%). It was followed by torsional-downbeat nystagmus, characterized by the upper pole of the unaffected eye beating toward the lower ear and vertically downward (164 cases, 25.3%). The former represented posterior canal excitatory nystagmus (PC-EN), while the latter represented posterior canal inhibitory nystagmus (PC-IN). In the PC-BPPV-cu group, PC-EN was most easily caused by the Half Dix-Hallpike (HH) maneuver on the affected side, while PC-IN was most easily induced by a face-down position (FDP) on the unaffected side at approximately 45° angle (45° FDP). The vertical slow phase velocity (v-SPV) of positional nystagmus was more potent in the affected HH than in other positions with PC-EN (all P < 0.05); the v-SPV of positional nystagmus was greater in the 45° FDP than in different positions with PC-IN (all P < 0.05); the v-SPV of the affected Dix-Hallpike (DH) maneuver in the PC-BPPV-ca group was significantly greater than that of the affected HH maneuver in the PC-BPPV-cu group (P < 0.05). The a priori analysis showed that the strongest correlation with HH positional nystagmus was observed in the affected side roll test, followed by the DH maneuver.
UNASSIGNED: In the PC-BPPV-cu group, the HH maneuver most easily induced PC-EN on the affected side, and PC-IN was most easily induced by the 45° FDP. In some cases of PC-BPPV-cu, significant nystagmus was not observed to be induced in the DH position on the affected side; however, vertical rotation nystagmus was induced in the roll-test position on the affected side. In such cases, PC-BPPV-cu diagnosis should be considered, and HH and 45° FDP tests should be conducted to support the diagnosis.
摘要：
■本研究旨在探讨后半规管杯管结石-良性阵发性位置性眩晕（PC-BPPV-cu）患者的位置性眼震特征，以提高临床诊断准确性。
■本研究回顾性分析了128例PC-BPPV-cu和128例BPPV肾小管结石（PC-BPPV-ca）。一般数据,强度,分布，比较两组患者位置性眼震的相关性。
■与PC-BPPV-ca组相比，PC-BPPV-cu组最初在急诊科就诊的病例较多(P<0.05)。PC-BPPV-cu引起的最常见的位置性眼震是扭转向上的眼震，特征是受影响的眼睛的上极向下耳和垂直向上跳动（387例，59.7%）。随后是扭转性眼球震颤，特征是未受影响的眼睛的上极向下耳和垂直向下跳动（164例，25.3%）。前者代表后管兴奋性眼球震颤（PC-EN），而后者代表后管抑制性眼球震颤（PC-IN）。在PC-BPPV-CU组中，PC-EN最容易由受影响一侧的半Dix-Hallpike（HH）操纵引起，而PC-IN最容易在未受影响的一侧以大约45°角（45°FDP）的面朝下位置（FDP）诱发。位置性眼球震颤的垂直慢相速度（v-SPV）在受影响的HH中比在PC-EN的其他位置中更有效（均P<0.05）；45°FDP中的位置性眼球震颤的v-SPV大于PC-IN的不同位置（均P<0.05）；受影响的Dix-Hallpike（PPPC）组的v-SPV显着大于BPC的BPC-先验分析表明，在受影响的侧滚试验中观察到与HH位置性眼球震颤的最强相关性，其次是DH演习。
■在PC-BPPV-cu组中，在受影响的一侧最容易引起PC-EN的HH机动，PC-IN最容易被45°FDP诱导。在某些情况下，PC-BPPV-CU，在患侧的DH位置未观察到明显的眼球震颤；然而，在患侧的滚动测试位置引起垂直旋转眼震。在这种情况下,应考虑PC-BPPV-CU诊断，应进行HH和45°FDP测试以支持诊断。
■本研究回顾性分析了128例PC-BPPV-cu和128例BPPV肾小管结石（PC-BPPV-ca）。一般数据,强度,分布，比较两组患者位置性眼震的相关性。
■与PC-BPPV-ca组相比，PC-BPPV-cu组最初在急诊科就诊的病例较多(P<0.05)。PC-BPPV-cu引起的最常见的位置性眼震是扭转向上的眼震，特征是受影响的眼睛的上极向下耳和垂直向上跳动（387例，59.7%）。随后是扭转性眼球震颤，特征是未受影响的眼睛的上极向下耳和垂直向下跳动（164例，25.3%）。前者代表后管兴奋性眼球震颤（PC-EN），而后者代表后管抑制性眼球震颤（PC-IN）。在PC-BPPV-CU组中，PC-EN最容易由受影响一侧的半Dix-Hallpike（HH）操纵引起，而PC-IN最容易在未受影响的一侧以大约45°角（45°FDP）的面朝下位置（FDP）诱发。位置性眼球震颤的垂直慢相速度（v-SPV）在受影响的HH中比在PC-EN的其他位置中更有效（均P<0.05）；45°FDP中的位置性眼球震颤的v-SPV大于PC-IN的不同位置（均P<0.05）；受影响的Dix-Hallpike（PPPC）组的v-SPV显着大于BPC的BPC-先验分析表明，在受影响的侧滚试验中观察到与HH位置性眼球震颤的最强相关性，其次是DH演习。
■在PC-BPPV-cu组中，在受影响的一侧最容易引起PC-EN的HH机动，PC-IN最容易被45°FDP诱导。在某些情况下，PC-BPPV-CU，在患侧的DH位置未观察到明显的眼球震颤；然而，在患侧的滚动测试位置引起垂直旋转眼震。在这种情况下,应考虑PC-BPPV-CU诊断，应进行HH和45°FDP测试以支持诊断。
