Benign paroxysmal positional vertigo

良性阵发性位置性眩晕
  • 文章类型: Journal Article
    目的:确定不同耳科手术前后新发和早发性良性阵发性位置性眩晕(BPPV)的发生率和临床特征。
    方法:对2021年1月至2023年5月在三级大学医院耳鼻咽喉科诊所进行的所有单侧耳科手术进行了筛查,437例成人病例纳入研究。在这些病人中,对术后1个月内诊断为BPPV的患者进行了检查.
    结果:耳科手术后BPPV的总发生率为2.28%(437例患者中有10例)。在使用钻头的情况下,该发生率为3%(8/266名患者),在不使用钻头的情况下,该发生率为1.16%(2/171名患者)。两组间无显著差别(p>0.05)。与BPPV相关的临床症状平均出现在手术后13.3±6.8(范围:3-25)天,并表现为泪管结石。所有病例均累及手术侧的后半规管(SCC)。此外,1例人工耳蜗植入患者的后部和外侧SCC均受累.所有患者在随访期间对重新定位动作反应良好。
    结论:耳科手术,特别是涉及钻井的操作,是BPPV发展的潜在风险因素。术后BPPV,主要表现为在手术侧的后部SCC中的泪管结石,可以通过重新定位机动进行有效管理。临床医生在耳科手术后四周内出现眩晕/头晕的患者应警惕BPPV。
    OBJECTIVE: To determine the frequency and clinical features of new- and early-onset benign paroxysmal positional vertigo (BPPV) after different otologic surgical operations with and without surgical drilling.
    METHODS: All unilateral otologic operations performed at the otolaryngology clinic of a tertiary university hospital between January 2021 and May 2023 were screened, and 437 adult cases were included in the study. Of these patients, those who were diagnosed with BPPV within the first month postoperatively were examined.
    RESULTS: The overall incidence of BPPV after otologic operations was 2.28% (10 out of 437 patients). This incidence was 3% (8/266 patients) in cases where a drill was used and 1.16% (2/171 patients) in those where a drill was not used. There was no significant difference between the two groups (p > 0.05). Clinical symptoms related to BPPV appeared on average in 13.3 ± 6.8 (range: 3-25) days following surgery and presented as canalolithiasis. All cases involved the posterior semicircular canal (SCC) on the operated side. In addition, one patient with a cochlear implant had involvement of both the posterior and lateral SCCs. All patients responded well to repositioning maneuvers during follow-up.
    CONCLUSIONS: Otologic surgery, especially operations involving drilling, is a potential risk factor for the development of BPPV. Postoperative BPPV, primarily presenting as canalolithiasis in the posterior SCC on the operated side, can be effectively managed with repositioning maneuvers. Clinicians should be vigilant for BPPV in patients experiencing vertigo/dizziness within four weeks following otologic surgery.
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  • 文章类型: Journal Article
    良性阵发性位置性眩晕(BPPV)是老年人最常诊断的头晕原因之一。
    调查75岁人群中BPPV的患病率和头晕和眼球震颤的位置症状,并确定与BPPV和位置头晕和眼球震颤相关的因素。
    在这项针对哥德堡75-78岁人群的横断面研究中,887名参与者接受了有关头晕,健康和社会因素的问题的检查。共有681名参与者使用VideoFrenzel护目镜进行了Dix-Hallpike测试或BPPV侧卧测试。
    总共32%报告了头晕问题(n=887)。BPPV的患病率在未加权分析中为4%,在加权分析中为4.5%,补偿女性和先前位置头晕的参与者的选择性减员。在2%中发现了无眼球震颤的位置性头晕,在9%中发现了无头晕的眼球震颤。与正常测试相比,患有BPPV和位置头晕的人在日常生活中经历了更多的头晕,而那些有位置性眼球震颤的人没有。
    估计75岁人群中BPPV的患病率为4.5%。尽管进行了加权分析,真实患病率可能更高,因为许多头晕患者拒绝检测.头晕与恐惧和不适有关,以至于大约20%的参与者拒绝测试。
    UNASSIGNED: Benign paroxysmal positional vertigo (BPPV) is one of the most frequently diagnosed cause of dizziness among older adults.
    UNASSIGNED: To investigate the prevalence of BPPV and positional symptoms of dizziness and nystagmus among 75-year-olds and to identify factors associated with BPPV and positional dizziness and nystagmus.
    UNASSIGNED: In this cross-sectional population-based study of 75-78-year-olds in Gothenburg, 887 participants were examined with questions regarding dizziness and health and social factors. A total of 681 participants underwent the Dix-Hallpike test or the side-lying test for BPPV using Video Frenzel goggles.
    UNASSIGNED: In total 32% reported problems with dizziness (n = 887). The prevalence of BPPV was 4% in the unweighted and 4.5% in the weighted analyses, compensating for selective attrition of women and participants with previous positional dizziness. Positional dizziness without nystagmus was found in 2% and nystagmus without dizziness was found in 9%. Individuals with BPPV and positional dizziness experienced more dizziness in everyday life compared with those with normal tests, while those with positional nystagmus did not.
    UNASSIGNED: The estimated prevalence of BPPV among 75-year-olds was 4.5%. Despite weighted analyses, the true prevalence may be higher since many participants with dizziness refused testing. Dizziness was associated with fear and discomfort so strong that around 20% of the participants declined testing.
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  • 文章类型: Journal Article
    Sleep disorders have a high comorbidity rate with vestibular diseases. The results of some small sample clinical studies have confirmed the effect of sleep deprivation on vestibular function. However, the mechanism of the effect of sleep disorder on vestibular system is still unclear. This article analyzes the possible mechanism of the effect of sleep disorders on vestibular function from the aspects of neuroanatomy and neurotransmitters, and summarizes the relationship between sleep disorder and benign paroxysmal positional vertigo, Meniere\'s disease, vestibular migraine and other diseases.
    摘要:睡眠障碍与前庭疾病有着较高的共患率。部分小样本的临床研究的结果证实了睡眠剥夺对前庭功能的影响。然而,睡眠障碍对前庭系统的影响机制尚不清楚,本文从神经解剖及神经递质方面分析睡眠障碍对前庭功能影响的可能机制,并对睡眠障碍与良性阵发性位置性眩晕、梅尼埃病、前庭性偏头痛等疾病的关系进行综述。.
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  • 文章类型: Journal Article
    良性阵发性位置性眩晕(BPPV)是一种常见的神经系统疾病,复发率高。2型糖尿病(T2DM)被认为是BPPV复发的危险因素。然而,T2DM和BPPV复发之间的基因组相关性仍未得到充分研究.
    使用差异基因表达分析和加权基因共表达网络分析来鉴定BPPV复发和T2DM之间的共有基因。MCC算法用于从共享基因的蛋白质-蛋白质相互作用网络中选择hub基因。使用ROC曲线分析评估hub基因对BPPV复发和T2DM的预测功效。Genemania数据库用于识别hub基因的下游靶标。使用CIBERSORT算法表征BPPV和T2DM的免疫浸润景观。通过相关性分析探讨hub基因与免疫细胞的关系。使用qPCR验证患者血液样品中hub基因的表达水平。
    鉴定了13个共有基因,并构建了BPPV复发和T2DM的蛋白质-蛋白质相互作用网络。随后,选择了四个hub基因,其表达水平可有效预测BPPV复发和T2DM的发生。这些hub基因与免疫细胞浸润高度相关,提示BPPV和T2DM复发的共同机制。最后,血液样本中证实了T2DM合并BPPV复发患者hub基因的上调.这些hub基因可作为预测生物标志物,用于评估伴有T2DM的BPPV患者的复发率。
    我们提出了BPPV复发和T2DM之间的共有基因特征,揭示了免疫介导的炎症调节是一个共同的途径,并确定了4种免疫相关的生物标志物和T2DM合并复发性BPPV的潜在治疗靶点。
    UNASSIGNED: Benign paroxysmal positional vertigo (BPPV) is a common neurological disorder with a high recurrence rate. Type 2 diabetes mellitus (T2DM) is recognized as a risk factor for BPPV recurrence. However, the genomic association between T2DM and BPPV recurrence remains understudied.
    UNASSIGNED: Differential gene expression analysis and weighted gene co-expression network analysis were used to identify shared genes between BPPV recurrence and T2DM. The MCC algorithm was employed to select hub genes from the protein-protein interaction network of the shared genes. The predictive efficacy of hub genes for BPPV recurrence and T2DM was assessed using ROC curve analysis. Genemania database was used to identify downstream targets of hub genes. The immune infiltration landscape of BPPV and T2DM was characterized using the CIBERSORT algorithm. Correlation analysis was performed to explore the relationship between hub genes and immune cells. The expression levels of hub genes in patient blood samples were validated using qPCR.
    UNASSIGNED: Thirteen shared genes were identified and a protein-protein interaction network was constructed for BPPV recurrence and T2DM. Subsequently, four hub genes were selected, and their expression levels effectively predicted the occurrence of BPPV recurrence and T2DM. These hub genes were highly correlated with immune cell infiltration, indicating a common mechanism underlying recurrent BPPV and T2DM. Finally, the upregulation of hub genes in patients with T2DM comorbid with BPPV recurrence was confirmed in blood samples. These hub genes may serve as predictive biomarkers for assessing the recurrence rate in BPPV patients with comorbid T2DM.
    UNASSIGNED: We proposed shared gene characteristics between BPPV recurrence and T2DM, revealing an immune-mediated inflammatory regulation as a common pathway and identifying four immune-related biomarkers and potential therapeutic targets for T2DM comorbid with recurrent BPPV.
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  • 文章类型: Case Reports
    良性阵发性位置性眩晕(BPPV)是一种常见的前庭病,涉及碳酸钙晶体溶解失败和向半规管中的错位。这会在头部位置变化期间引起短暂的眩晕。通常,BPPV可以在一次临床访问中解决,但仅次于许多已知的危险因素,BPPV可以复发。尽管缺乏已知的危险因素,但该病例报告仍是复发极为频繁的患者。2022年12月,一名55岁的女性经历了BPPV,并成功进行了耳鼻喉科的耳石重新定位治疗。在2023年3月复发后,患者接受了视频眼震描记术,包括热量测试,MRI,除左后管BPPV外,所有检查结果均正常。从2022年12月到2024年2月,患者有13次复发,每个都被处理成分辨率,通过重复位置测试和每个主观报告至少2周后确认。据报道,女性BPPV复发率较高,然而,这不能解释为一个致病因素。尽管文献中记载了许多其他风险因素,这个病人的病史,人口统计,成像,验血结果都是阴性.该病例报告强调了前庭病理生理学知识的差距,因为这个病人的高复发率仍然无法解释。
    Benign paroxysmal positional vertigo (BPPV) is a common vestibulopathy and involves failed dissolution and dislocation of calcium carbonate crystals into the semicircular canal. This causes short-lasting vertigo during changes in head position. Oftentimes, BPPV can be resolved within a single clinic visit, but secondary to many known risk factors, BPPV can recur. This case report follows a patient with extremely frequent recurrences despite a lack of known risk factors. A 55-year-old female experienced BPPV in December 2022, with successful canalith repositioning treatment from otolaryngology. On having a recurrence in March 2023, the patient underwent videonystagmography including caloric testing, and MRI, all of which showed normal findings besides left posterior-canal BPPV. From December 2022 to February 2024, the patient had 13 recurrences, each treated to resolution, confirmed by repeating positional tests and per subjective report for at least 2 weeks following. The incidence of BPPV recurrence is reported higher in females, however, this could not be interpreted as a causative factor. Though many other risk factors are documented in literature, this patient\'s history, demographics, imaging, and blood tests were all negative. This case report highlights a gap in knowledge of vestibular pathophysiology, as this patient\'s high rate of recurrence remains unexplained.
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  • 文章类型: Journal Article
    本文对国内外良性阵发性位置性眩晕(BPPV)的研究现状和重点领域进行了评价,并对今后的研究方向进行了预测。从2002年1月1日至2021年12月31日搜索了WebofScience核心合集。进行了文献计量和统计分析,以生成出版物的基本信息。共确定了1255种出版物,2019年至2021年,年度出版物数量呈增长趋势。《耳科学与中子学》是最有成效的期刊。KimJ,KimC,和来自韩国的LeeJ是前3名富有成效的作者。首尔国立大学是最具影响力的机构。引用的前5个突发关键字包括复发,骨质疏松,骨矿物质密度,维生素D缺乏,和BPPV。每年的出版物数量将继续增长。BPPV的未来研究将集中在骨质疏松症和复发。
    This article evaluated the current status and focus areas in benign paroxysmal positional vertigo (BPPV) research in the world and to predict the direction of future research. Web of Science Core Collection were searched from January 1, 2002, to December 31, 2021. Bibliometric and statistical analysis were conducted to generate the basic information of the publications. A total of 1255 publications were identified, with an increasing trend in the number of annual number of publications from 2019 to 2021. Otology & Neurotology was the most productive journal. Kim J, Kim C, and Lee J from South Korea were the top 3 productive authors. Seoul National University is the most influential institution. The top 5 cited burst keywords include recurrence, osteoporosis, bone mineral density, vitamin D deficiency, and BPPV. The annual number of publications would continue to grow. The future research of BPPV will concentrate on osteoporosis and recurrence.
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  • 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: Published Erratum
    [这更正了文章DOI:10.3389/freur.2024.1382196。].
    [This corrects the article DOI: 10.3389/fneur.2024.1382196.].
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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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