Benign Paroxysmal Positional Vertigo

良性阵发性位置性眩晕
  • 文章类型: Journal Article
    目的:良性阵发性位置性眩晕(BPPV)在大多数情况下可以成功治疗。然而,复发是常见的。我们旨在前瞻性调查BPPV复发的人口统计学和临床危险因素。我们的第二个目的是调查季节性是否影响复发。
    方法:我们招募了在我们的头晕诊所诊断为明确或可能的BPPV的荷兰成年患者,进行为期1年的前瞻性观察研究。从患者病史和问卷中收集的因素是年龄,性别,种族,以前对BPPV的治疗,BPPV症状的持续时间,初始BPPV发作的治疗次数,受影响的运河,最近头部外伤,有前庭神经炎病史,梅尼埃病,(前庭)偏头痛,痛风,糖尿病,慢性肾功能衰竭.来自血液样本的因素是尿酸,糖化血红蛋白,和25-羟基维生素D。
    结果:我们包括139名平均年龄为65岁的受试者(SD,13)年,其中70%是女性。在1年的随访中,共有48名受试者(34.5%)至少有一次复发。BPPV复发的独立危险因素是“初次BPPV发作的多次治疗”(发生率比,1.74;95%置信区间1.06-2.85;p=0.027)和痛风病史(发病率比,1.90;95%置信区间,1.01-3.57;p=0.045)。
    结论:在三级头晕门诊就诊的患者中,有三分之一在1年内出现至少一次BPPV复发。多次治疗和痛风病史是复发的独立危险因素。
    OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) can be treated successfully in most cases. However, recurrences are common. We aimed to prospectively investigate demographic and clinical risk factors for BPPV recurrence. Our second aim was to investigate whether seasonality affects recurrences.
    METHODS: We recruited adult Dutch patients presenting at our dizziness clinic with a diagnosis of definite or possible BPPV for a prospective observational study with 1-year follow-up. Factors collected from patient history and questionnaires were age, sex, ethnicity, previous treatment for BPPV, duration of BPPV symptoms, number of treatment sessions for the initial BPPV episode, the affected canal, recent head trauma, and a history of vestibular neuritis, Menière\'s disease, (vestibular) migraine, gout, diabetes mellitus, and chronic renal failure. Factors derived from blood samples were uric acid, glycated hemoglobin, and 25-hydroxyvitamin D.
    RESULTS: We included 139 subjects with a mean age of 65 (SD, 13) years, of whom 70% was female. A total of 48 subjects (34.5%) suffered from at least one recurrence during the 1-year follow-up. Independent risk factors for recurrence of BPPV were \"multiple treatment sessions for the initial BPPV episode\" (incidence rate ratio, 1.74; 95% confidence interval 1.06-2.85; p = 0.027) and history of gout (incidence rate ratio, 1.90; 95% confidence interval, 1.01-3.57; p = 0.045).
    CONCLUSIONS: One-third of patients presenting in a tertiary dizziness clinic develop at least one recurrence of BPPV within 1 year. Multiple treatment sessions and a history of gout are independent risk factors for recurrence.
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  • 文章类型: Journal Article
    评价视频眼震描记术引导下Epley手法对后管良性阵发性位置性眩晕患者生活质量的改善。本研究的设计是横断面分析研究。这项研究是在耳鼻咽喉科进行的,SriAurobindo医学院和研究生研究所,Indore与SriAurobindo言语和听力研究所合作,印多尔.目前的研究旨在评估在后管良性阵发性位置性眩晕中使用和不使用药物治疗的耳石重新定位程序(Epley's手法)的有效性,并根据头晕障碍量表评估患者。所有来SriAurobindo医学院和研究生学院ENTOPD的患者,在研究中选择指定持续时间内并根据纳入标准的印度。大多数患者的年龄为18-58岁,中位年龄为32岁,在Epley的操作和DHI的15天主观症状缓解,60名受试者中有46名报告症状缓解,百分比为76.6%。该组46名具有症状缓解的受试者被标记为缓解组。已解决组的年龄范围为18至58岁。剩下14个科目,标记为复发组的患者被处方为β-histine,并重复进行Epley操作以评估辅助治疗的有效性.我们得出的结论是,单个视频眼震描记术引导的Epley动作是有效康复大多数后管BPPV的绝佳工具,单独和辅助倍他司汀治疗甚至可以治愈难治性病例,为他们提供更好的生活质量。
    To assess Quality of life improvement in Videonystagmography guided Epley\'s Manoeuvre in posterior canal benign paroxysmal positional vertigo. The design of present study is cross-sectional analytical study. The study is conducted in the Department of Otorhinolaryngology, Sri Aurobindo Medical College and Post Graduate Institute, Indore in association with Sri Aurobindo Institute of speech and hearing, Indore. Current study done to assess the effectiveness of canalolith repositioning procedures (Epley\'s maneuver) with and without drug therapy in posterior canal benign paroxsymal positional vertigo and to assess the patients based on Dizziness Handicap Inventory. All Patients who come to ENT OPD at Sri Aurobindo Medical College and Post Graduate Institute, Indore in the specified duration and according to the inclusion criteria were chosen in the study. Majority of the patients were in the age group of 18-58 years with the median age of 32 and subjective symptomatic relief on Epley\'s manoeuvre and DHI on day 15, 46 out of 60 subjects reported symptomatic relief with a percentage of 76.6%. This group of 46 subjects with symptomatic relief was labeled as resolved group. The age range in resolved group was between 18 and 58 years. Remaining 14 subjects, labelled as relapsed group were prescribed beta-histine and repeat Epley\'s maneuver was performed to assess the effectiveness of adjunct therapy. We conclude that a single Videonystagmography guided Epley\'s maneuver is an excellent tool for effective rehabilitation of majority of posterior canal BPPV alone and combined with adjunct betahistine therapy can even cure refractory cases providing them with better quality of life.
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  • 文章类型: Journal Article
    背景:这项研究评估了Epley机动与Dizzy-Fix训练装置结合治疗良性阵发性位置性眩晕(BPPV)的有效性,旨在提高治疗效果和患者满意度。
    方法:在这项随机对照试验中,50例诊断为后管BPPV的患者被分为两组:一组接受传统的Epley机动,另一组接受补充Dizzy-Fix训练装置的Epley机动。主要指标包括一个月无症状患者的比例,视觉模拟量表(VAS)和头晕障碍量表(DHI)评分的变化,一个月内的复发率,患者满意度。
    结果:到第7天,Dizzy-Fix组的症状缓解率明显更高(90%vs.60%),并报告患者满意度更高(4.5/5vs.3.8/5)与单独的Epley机动组相比。此外,该组表现出DHI评分更大幅度的下降(从平均30到5)和较低的复发率(10%vs.40%)在治疗后的第一个月内。
    结论:将Dizzy-Fix训练装置与Epley机动相结合可显著改善BPPV的管理,更快的症状解决证明,提高患者满意度,减少症状复发。这些发现强调了在前庭康复中整合实时视觉反馈技术的价值,有希望更好的患者结果,并提高BPPV治疗的护理质量。
    BACKGROUND: This study evaluates the effectiveness of combining the Epley Maneuver with the Dizzy-Fix Training Device in treating Benign Paroxysmal Positional Vertigo (BPPV), aiming to enhance treatment outcomes and patient satisfaction.
    METHODS: In this randomized controlled trial, 50 patients diagnosed with posterior canal BPPV were allocated into two groups: one receiving the traditional Epley Maneuver and the other undergoing the Epley Maneuver supplemented with the Dizzy-Fix Training Device. Key measures included the proportion of symptom-free patients at one month, changes in the Visual Analogue Scale (VAS) and Dizziness Handicap Inventory (DHI) scores, the recurrence rate within one month, and patient satisfaction.
    RESULTS: The Dizzy-Fix group achieved a significantly higher symptom resolution rate by day 7 (90% vs. 60%) and reported greater patient satisfaction (4.5/5 vs. 3.8/5) compared to the Epley Maneuver alone group. Additionally, this group exhibited a more substantial decrease in DHI scores (from an average of 30 to 5) and a lower recurrence rate (10% vs. 40%) within the first month post-treatment.
    CONCLUSIONS: Incorporating the Dizzy-Fix Training Device with the Epley Maneuver significantly improves the management of BPPV, evidenced by faster symptom resolution, enhanced patient satisfaction, and reduced symptom recurrence. These findings underscore the value of integrating real-time visual feedback technologies in vestibular rehabilitation, promising better patient outcomes, and advancing the quality of care in BPPV treatment.
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  • 文章类型: Journal Article
    背景/目的:良性阵发性位置性眩晕(BPPV)是复发性眩晕的最常见原因,也是最常见的周围性前庭疾病。它的特征是由头部和位置变化引发的剧烈眩晕。本研究调查了BPPV患者后续损伤的风险和治疗效果。方法:使用台湾2005年纵向健康保险数据库的数据进行了一项基于人群的回顾性队列研究。在2000年至2017年之间确定了有和没有BPPV的患者。研究结果是全因损伤的诊断。Kaplan-Meier方法确定了两个队列中损伤的累积发生率,并通过对数秩检验分析了差异。Cox比例风险模型计算了每个队列的18年风险比(HR)。结果:我们招募了50,675例新诊断的BPPV患者和202,700例无BPPV的匹配个体。随访期间,47,636例患者被诊断为受伤(BPPV队列中的13,215例和非BPPV队列中的34,421例)。BPPV患者损伤的校正HR为2.63(95%CI,2.49-2.88)。亚组分析显示,BPPV患者的意外和故意伤害发生率增加(aHR2.86;95%CI,2.70-3.13和1.10;95%CI,1.04-1.21)。随着BPPV诊断的增加,观察到了正的剂量反应关系。用牙石复位治疗(CRT)或药物治疗轻微但不显著降低损伤风险(aHR,0.78;95%CI,分别为0.37-1.29、0.88;95%CI,分别为0.40-1.40)。结论:BPPV与损伤风险增加独立相关。CRT或药物对减轻这种风险的作用有限。医生应建议BPPV患者采取预防措施,即使在治疗后也要防止受伤。
    Background/Objectives: Benign paroxysmal positional vertigo (BPPV) is the most common cause of recurrent vertigo and the most common peripheral vestibular disorder. It is characterized by intense vertigo triggered by head and position changes. This study investigates the risk of subsequent injury in BPPV patients and the effects of treatment. Methods: A population-based retrospective cohort study was conducted using data from the Longitudinal Health Insurance Database 2005 in Taiwan. Patients with and without BPPV were identified between 2000 and 2017. The study outcomes were diagnoses of all-cause injuries. The Kaplan-Meier method determined the cumulative incidence rates of injury in both cohorts, and a log-rank test analyzed the differences. Cox proportional hazard models calculated each cohort\'s 18-year hazard ratios (HRs). Results: We enrolled 50,675 patients with newly diagnosed BPPV and 202,700 matched individuals without BPPV. During follow-up, 47,636 patients were diagnosed with injuries (13,215 from the BPPV cohort and 34,421 from the non-BPPV cohort). The adjusted HR for injury in BPPV patients was 2.63 (95% CI, 2.49-2.88). Subgroup analysis showed an increased incidence of unintentional and intentional injuries in BPPV patients (aHR 2.86; 95% CI, 2.70-3.13 and 1.10; 95% CI, 1.04-1.21, respectively). A positive dose-response relationship was observed with increasing BPPV diagnoses. Treatment with canalith repositioning therapy (CRT) or medications reduced the risk of injury slightly but not significantly (aHR, 0.78; 95% CI, 0.37-1.29, 0.88; 95% CI, 0.40-1.40, respectively). Conclusions: BPPV is independently associated with an increased risk of injuries. CRT or medications have limited effects on mitigating this risk. Physicians should advise BPPV patients to take precautions to prevent injuries even after treatment.
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  • 文章类型: Journal Article
    背景:本研究旨在使用基于人群的数据集调查外周前庭疾病与1型和2型糖尿病的相关性。
    方法:本研究的数据来自台湾的2010年纵向健康保险数据库。样本包括150,916例新诊断为周围前庭疾病的患者和452,748例没有周围前庭疾病的倾向评分匹配对照。我们利用多变量逻辑回归模型来定量评估外周前庭疾病和糖尿病之间的关联,同时考虑性别等因素。年龄,地理位置,月收入,患者居住地的城市化水平,冠心病,高血压,和高脂血症。
    结果:卡方测试表明,与对照组相比,糖尿病在周围前庭障碍组中更常见(20.6%vs.15.1%,p<0.001)。在所有样本患者中,与对照组相比,患有外周前庭疾病的糖尿病的校正比值比为1.597(95%CI=1.570〜1.623),而患有梅尼埃病的患者,良性阵发性位置性眩晕,单侧前庭病,和其他周围性前庭疾病的糖尿病的调整比值比分别为1.566(95%CI=1.498〜1.638),1.677(95%CI=1.603~1.755),1.592(95%CI=1.504~1.685),与对照组相比,为1.588(95%CI=1.555~1.621)。
    结论:我们的研究揭示了糖尿病与外周前庭疾病易感性增加之间的关联。
    BACKGROUND: This study aimed to investigate the association of peripheral vestibular disorders with type 1 and type 2 diabetes using a population-based dataset.
    METHODS: The data for this study were obtained from Taiwan\'s Longitudinal Health Insurance Database 2010. The sample consisted of 150,916 patients who were newly diagnosed with peripheral vestibular disorders as cases and 452,748 propensity-score-matching controls without peripheral vestibular disorders. We utilized multivariate logistic regression models to quantitatively evaluate the association between peripheral vestibular disorders and diabetes while considering factors such as sex, age, geographic location, monthly income, urbanization level of the patient\'s residence, coronary heart disease, hypertension, and hyperlipidemia.
    RESULTS: The chi-squared test indicates that diabetes was more common in the peripheral vestibular disorder group compared to controls (20.6% vs. 15.1%, p < 0.001). Of all sampled patients, the adjusted odds ratio for diabetes was 1.597 (95% CI = 1.570~1.623) for those with peripheral vestibular disorders when compared to controls, while patients with Ménière\'s disease, benign paroxysmal positional vertigo, unilateral vestibulopathy, and other peripheral vestibular disorders had respective adjusted odds ratios of diabetes at 1.566 (95% CI = 1.498~1.638), 1.677 (95% CI = 1.603~1.755), 1.592 (95% CI = 1.504~1.685), and 1.588 (95% CI = l.555~1.621) in comparison to controls.
    CONCLUSIONS: Our research has revealed an association between diabetes and an increased susceptibility to peripheral vestibular disorders.
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  • 文章类型: Journal Article
    目的:通过头部横摆试验(HYT)观察眼球震颤方向并根据Ewald规律比较两侧眼球震颤强度,诊断为外侧半规管BPPV(LSC-BPPV)。头部俯仰试验(HPT)是一种在直立位置进行的诊断操作,方法是将患者的头部向前弯曲(弯曲)和向后弯曲(倾斜)并观察诱发的眼震。我们旨在通过定量测量弯曲和倾斜眼球震颤慢相速度(SPV)来评估HPT在正确诊断LSC-BPPV中的敏感性。
    方法:前瞻性纳入100例LSC-BPPV。进行了HPT,寻找伪自发的,鞠躬,倾斜眼球震颤.最终诊断考虑HYT。如果眼球震颤出现在至少一个位置,则将HPT定义为“诊断”,如果未检测到眼球震颤,则为“非诊断性”。分析并比较所有位置的眼球震颤的方向和SPV,以确定HPT和HYT之间的一致程度。
    结果:诊断出64种向地和36种向外型。80例诊断为HPT,这两种形式没有区别。根据Ewald的法律,HPT诱发的更强眼球震颤的方向与HYT结果一致,其中39/52例(75%)为向地形式,21/28例(75%)为向地形式。考虑到所有病例,HPT和HYT之间的协议是“实质性的”,仅考虑诊断为HPT的患者,“几乎完全”。
    结论:定量HPT是诊断LSC-BPPV的受影响侧和形式的有效测试,即使不如HYT可靠。
    OBJECTIVE: Lateral semicircular canal BPPV (LSC-BPPV) is diagnosed with the Head Yaw Test (HYT) by observing nystagmus direction and comparing the nystagmus intensity on both sides according to Ewald\'s laws. Head Pitching Test (HPT) is a diagnostic maneuver performed in the upright position by bending the patient\'s head forward (bowing) and backward (leaning) and observing the evoked nystagmus. We aimed to assess the sensitivity of HPT in correctly diagnosing LSC-BPPV through the quantitative measurement of Bowing and Leaning nystagmus slow-phase velocity (SPV).
    METHODS: One hundred cases of LSC-BPPV were prospectively enrolled. HPT was performed, looking for pseudospontaneous, bowing, and leaning nystagmus. HYT was considered for the \"final diagnosis.\" HPT was defined as \"diagnostic\" if the nystagmus was present in at least one position, \"undiagnostic\" if no nystagmus was detectable. The direction and the SPV of nystagmus in all positions were analyzed and compared to determine the degree of agreement between HPT and HYT.
    RESULTS: Sixty-four geotropic and 36 apogeotropic forms were diagnosed. HPT was diagnostic in 80 cases, with no difference between the two forms. According to Ewald\'s laws, the direction of stronger nystagmus evoked by HPT agreed with the HYT results in 39/52 (75%) cases in geotropic forms and 21/28 (75%) cases in apogeotropic forms. The agreement between HPT and HYT was \"substantial\" considering all the cases and \"almost complete\" considering only the patients with diagnostic HPT.
    CONCLUSIONS: Quantitative HPT is a valid test in diagnosing the affected side and form of LSC-BPPV, even if less reliable than HYT.
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  • 文章类型: Journal Article
    背景:为了检查3D(维度)前庭康复治疗(VRT)对步态的有效性,平衡问题,与对照组(CG)相比,良性阵发性位置性眩晕(BPPV)患者的处理时间速度和主观主诉。本研究旨在测试基于虚拟现实的3D游戏与前庭康复的可行性。
    方法:22例BPPV患者(DixHallpike/Roll试验结果阴性,现有的头晕/平衡投诉)随机分配到研究组(SG,n:113D-VRT)或对照组(CGn:11,无运动康复),为期8周。SG执行3D-VRT45至50分钟/天,3次/周,CG确实只收到了Canalith重新定位机动(CRM)。研究前两组均采用CRM。结果测量包括10米步行测试(10-MWT)(有/没有头转弯),动态步态指数(DGI)选择步进反应时间(CSRT-MAT),富勒顿高级平衡秤(FAB),和视觉模拟量表(VAS)。
    结果:SG在没有(p5=0.00,η2=0.49)的情况下显示出10-MWT的显着改善,水平(p5=0.00,η2=0.57),垂直(p5=0.01,η2=0.48)头转弯,DGI(p5=0.00,η2=0.74),CSRT-MAT,FAB(p5=0.00,η2=0.78)和VAS-头晕(p5=0.00,η2=0.65),VAS平衡问题(p5=0.00,η2=0.43),VAS-与CG相比对跌倒的恐惧(p5=0.00,η2=0.42)。
    结论:3D-VRT可有效改善步态,balance,处理速度和解决BPPV中的主观投诉。3D-VRT方法对于CRM后残留头晕或平衡不适的患者是可行的。此外,3D-VRT比其他虚拟现实应用程序更易于访问且更便宜,这可能有助于进一步的研究或临床使用。
    BACKGROUND: To examine the effectiveness of 3D (dimensional)-vestibular rehabilitation therapy (VRT) on gait, balance problems, processing time speed and subjective complaints in patients with Benign Paroxysmal Positional Vertigo (BPPV) compared to a control group (CG). This study aimed to test the feasibility of virtual reality-based 3D exergaming conjunction with vestibular rehabilitation.
    METHODS: Twenty-two patients with BPPV (negative DixHallpike/Roll test results, existing dizziness/balance complaints) were randomly allocated to the study group (SG, n:11 3D-VRT) or Control group (CG n:11, no exercise-rehabilitation) for 8 week. The SG performed 3D-VRT for 45 to 50 min/d, 3 times/wk, and the CG did receive only Canalith Repositioning Maneuver (CRM). CRM was applied in both groups before the study. Outcome measures included 10-Meter-Walk-Test (10-MWT) (with/without head turns), Dynamic Gait Index (DGI), Choice-Stepping-Reaction-Time-ped (CSRT-MAT), Fullerton Advanced Balance Scale (FAB), and Visual Analog Scale (VAS).
    RESULTS: The SG showed significantly improvement in 10-MWT without (p5 = 0.00,η2 = 0.49), with horizontal (p5 = 0.00,η2 = 0.57),vertical (p5 = 0.01,η2 = 0.48) head turns, DGI (p5 = 0.00,η2 = 0.74), CSRT-MAT, FAB (p5 = 0.00,η2 = 0.78) and VAS-dizziness (p5 = 0.00,η2 = 0.65), VAS-balance problem (p5 = 0.00,η2 = 0.43), VAS-fear of falling (p5 = 0.00,η2 = 0.42) compared to the CG.
    CONCLUSIONS: The 3D-VRT were effective in improving gait, balance, processing speed and resolving the subjective complaints in BPPV. The 3D-VRT method is feasible for patients who suffer from residual dizziness or balance complaints after CRM. Furthermore, the 3D-VRT is more accessible and less expensive than other virtual reality applications, which may facilitate further research or clinical use.
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  • 文章类型: Journal Article
    目的:这项初步研究旨在评估针对初级保健物理治疗师的培训计划,重点是评估和管理良性阵发性位置性眩晕。
    方法:开发了一个为期六个月的培训计划和工具包,该计划和工具包利用了经修订的《卓越质量改进报告标准》(“SQUIRE2.0”)指南,以促进学习新知识和技能。遵循加涅的教学设计模型,评估和管理良性阵发性位置性眩晕。培训前和培训后的知识和信心调查表评估了培训计划的影响。
    结果:11名参与者开始了培训计划,5名参与者完成了培训计划。平均而言,知识增加了54%(范围,41-95%),信心增加45%(范围,31-76%)。在最初的培训课程之后,实践技能的获得提高了73%。
    结论:结构化的学习方法显示了知识的改进,物理治疗师在良性阵发性位置性眩晕的循证管理中的技能和信心。
    OBJECTIVE: This pilot study aimed to evaluate a training programme for primary care physiotherapists focused on the assessment and management of benign paroxysmal positional vertigo.
    METHODS: A six-month training programme and toolkit utilising the revised Standards for Quality Improvement Reporting Excellence (\'SQUIRE 2.0\') guidelines was developed to facilitate the learning of new knowledge and skills in the assessment and management of benign paroxysmal positional vertigo following Gagne\'s model of instructional design. A pre- and post-training knowledge and confidence questionnaire evaluated the impact of the training programme.
    RESULTS: Eleven participants started the training programme and five completed it. On average, knowledge increased by 54 per cent (range, 41-95 per cent) and confidence increased by 45 per cent (range, 31-76 per cent). A 73 per cent improvement in practical skills acquisition was demonstrated after the initial training session.
    CONCLUSIONS: A structured approach to learning demonstrates improvements in knowledge, skills and confidence of physiotherapists in the evidence-based management of benign paroxysmal positional vertigo.
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  • 文章类型: Journal Article
    良性阵发性位置性眩晕(BPPV)与各种精神障碍之间的关联仍然存在争议。本研究使用孟德尔随机化(MR)方法来阐明BPPV与7种精神障碍(双相情感障碍,抑郁症,焦虑症,精神分裂症,自杀,神经质,和情绪波动),以帮助探索BPPV并发症以及预防和早期治疗精神障碍。
    BPPV和7种精神障碍的数据集从全基因组关联研究(GWAS)获得。双样本MR用于分析暴露(BPPV)与各种结局(双相情感障碍,抑郁症,焦虑症,精神分裂症,自杀,神经质,和情绪波动)。还进行了反向MR研究。方差逆加权(IVW)方法,MR-Egger方法,简单模式方法,加权模式法,并选用加权中位数法。
    MR分析和反向MR分析结果未揭示BPPV和双相情感障碍之间的显著关联,抑郁症,焦虑症,精神分裂症,自杀倾向,神经质,和情绪波动。有趣的是,神经质(IVW:OR=1.142,95%CI:1.059-1.231,P=0.001;P-MR-PRESSO调整=0.0002)和情绪波动(IVW:OR=3.119,95%CI:1.652-5.884,P=0.0004)可能与BPPV有显著关联。MR-PRESSO调整后,没有水平多效性或异质性,和神经质之间的显著关联,情绪波动,和BPPV仍然被建议。
    我们对来自欧洲人群的遗传数据进行了MR分析,发现了BPPV与七种精神障碍之间的因果关系。我们的研究结果表明,BPPV可能与双相情感障碍没有显著的因果关系,抑郁症,焦虑症,精神分裂症,或者自杀倾向.然而,神经质和情绪波动可能是BPPV的危险因素。
    UNASSIGNED: The association between benign paroxysmal positional vertigo (BPPV) and various mental disorders is still controversial. This study used the Mendelian randomization (MR) method to clarify the correlation between BPPV and seven mental disorders (bipolar disorder, depression, anxiety disorder, schizophrenia, suicidality, neuroticism, and mood swings) to aid in the exploration of BPPV complications and prevention and early treatment of mental disorders.
    UNASSIGNED: The datasets for BPPV and seven mental disorders were obtained from genome-wide association studies (GWASs). Two-sample MR was used to analyze the correlation between exposure (BPPV) and various outcomes (bipolar disorder, depression, anxiety disorder, schizophrenia, suicidality, neuroticism, and mood swings). A reverse MR study was also performed. The inverse variance weighting (IVW) method, the MR-Egger method, the simple mode method, the weighted mode method, and the weighted median method were selected.
    UNASSIGNED: The MR analysis and the reverse MR analysis results did not reveal significant associations between BPPV and bipolar disorder, depression, anxiety disorder, schizophrenia, suicidal tendencies, neuroticism, and mood swings. Interestingly, neuroticism (IVW: OR = 1.142, 95% CI: 1.059-1.231, P = 0.001; P-MR-PRESSO adjustment = 0.0002) and mood swings (IVW: OR = 3.119, 95% CI: 1.652-5.884, P = 0.0004) may have a significant association with BPPV. After MR-PRESSO adjustment, there was no horizontal pleiotropy or heterogeneity, and a significant association between neuroticism, mood swings, and BPPV has still been suggested.
    UNASSIGNED: We conducted MR analysis on genetic data from European populations and discovered a causal relationship between BPPV and the seven mental disorders. Our research findings suggest that BPPV may not have a significant causal relationship with bipolar disorder, depression, anxiety disorder, schizophrenia, or suicidal tendencies. However, neuroticism and mood swings may be risk factors for BPPV.
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  • 文章类型: Journal Article
    背景:良性阵发性位置性眩晕(BPPV)是外周性眩晕的最常见原因之一。通过改变头部位置以使耳科碎屑从受影响的运河回落到岩心,可以进行各种耳石重新定位操作。本研究比较了后管BPPV患者采用改良的Epley动作与Semont动作的眩晕恢复率。
    方法:本临床试验包括通过Dix-Hallpike试验阳性诊断为后管BPPV的一百七十例患者。使用视觉模拟量表对眩晕进行主观分析。使用抽奖方法通过简单随机分组将85名患者分为两组。修改后的Epley的动作被分配给一组,Semont的动作被分配给另一组。2周后,他们被召回,以重复Dix-Hallpike和VAS进行临床评估。
    结果:两周后重复Dix-Hallpike动作,发现改良Epley和Semont组95.3%和90.6%的患者有所改善,分别。在第二次演习之后,在Semont的操作中,分辨率明显高于100%(8/8患者),相比之下,改良Epley的策略为25%(4例患者中有1例)。已发现第0天的VAS和第2周的VAS的平均值的比较具有统计学显著性(P值<0.001)。
    结论:Epley和Semont的策略在治疗BPPV方面同样有效。然而,使用Semont的动作需要较少的重复动作才能完全缓解患者的症状。Semont的操作也相对更容易执行,位置变化较少,需要更少的时间,并且没有操纵后行动限制的要求。因此,建议Semont的操作可常规用于PCBPPV的治疗,尤其是在老年人和有脊柱问题的患者中。
    BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is one of the commonest causes of peripheral vertigo. It is treated with various canalolith repositioning manoeuvres by changing the head positions to allow the otoconial debris to fall back from the affected canal back to the utricle. The present study has compared the rate of recovery of vertigo with modified Epley\'s manoeuvres as compared to Semont\'s manoeuvre in patients with posterior canal BPPV.
    METHODS: One hundred and seventy patients diagnosed by positive Dix-Hallpike test as posterior canal BPPV were included in this clinical trial. Subjective analysis of vertigo was done using visual analogue scale. 85 patients each were recruited in two arms by simple randomization using lottery method. Modified Epley\'s manoeuvre was administered to one group and Semont\'s manoeuvre to the other. They were recalled after 2 weeks for clinical assessment with repeat Dix-Hallpike and VAS.
    RESULTS: Repeat Dix-Hallpike manoeuvres after two weeks revealed that 95.3 and 90.6% patients improved in Modified Epley\'s and Semont\'s group, respectively. After the second manoeuvre, the resolution rate was significantly higher in Semont\'s manoeuvre 100% (8 out of 8 patients), as compared to 25% (1 out of 4 patients) in Modified Epley\'s manoeuvre. Comparison of the mean values of VAS day 0 and VAS 2 weeks has been found to be statistically significant (p value of < 0.001).
    CONCLUSIONS: Both Epley\'s and Semont\'s manoeuvre are equally efficacious in treatment of BPPV. However, use of Semont\'s manoeuvre required fewer repeat manoeuvres for complete resolution of symptoms in patients. The Semont\'s manoeuvre is also comparatively easier to perform with less number of position changes, takes less time, and has no requirement of post-manoeuvre mobility restrictions. Hence, it is recommended that Semont\'s manoeuvre can be routinely used for the management of PC BPPV especially in older population and patients with spinal problems.
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