前庭性偏头痛并发良性阵发性位置性眩晕临床特征分析  

Clinical Analysis of Benign Paroxysmal Positional Vertigo Associated with Vestibular Migraine

作　　者：欧阳汤鹏 徐先荣 翟丽红 石婷婷 Ouyang Tangpeng;Xu Xianrong;Zhai Lihong;Shi Tingting(Vertigo Clinic Research Center of Aerospace,Air Force Special Medical Center,Beijing,100142,China;Vertigo Clinic Research Center of Qingdao Special Recuperate Center of PLA Navy,Qingdao,266000,China;不详)

机构地区：[1]空军特色医学中心航空航天眩晕诊疗研究中心,北京100142 [2]海军青岛特勤疗养中心眩晕诊疗中心

出　　处：《听力学及言语疾病杂志》2021年第6期604-608,共5页Journal of Audiology and Speech Pathology

基　　金：全军后勤标准制定项目(BKJ15B013)。

摘　　要：目的探讨前庭性偏头痛(vestibular migraine,VM)并发良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床特征。方法回顾性分析2017年11月至2019年10月于空军特色医学中心眩晕中心就诊的62例VM并发BPPV(并发组)及65例原发性BPPV(原发组)患者的临床资料,统计分析两组患者年龄、性别、受累半规管、复位次数、复发率、冷热试验及前庭自旋转试验(vestibular autorotation test,VAT)异常率等特点。结果并发组与原发组男女比例分别为1∶5.2和1∶1.7,差异有统计学意义(P<0.05)。并发组与原发组水平半规管受累检出率分别为40.3%(25/62)、23.1%(15/65),前者高于后者,差异有统计学意义(P<0.05)。并发组在服用抗VM药物治疗同时所需复位治疗次数及复发率与原发组比较差异无统计学意义(P>0.05)。并发组与原发组VAT异常者分别为69.4%(43/62)和52.3%(34/65),差异有统计学意义(P<0.05);二组间冷热试验异常率(分别为29.0%和15.4%)差异无统计学意义(P>0.05)。结论VM并发BPPV常见于中老年女性,水平半规管更易受累,大部分患者在抗VM药物治疗同时经过1~2次复位治疗即可控制眩晕,前庭功能检查VAT异常率高于冷热试验。Objective To investigate the clinical characteristics of benign paroxysmal positional vertigo(BPPV)associated with vestibular migraine(VM).Methods A retrospective analysis of medical records,including patients’age,gender,affected semicircular canal,times of repositioning maneuver,medication,abnormity rate of caloric test and vestibular autorotation test(VAT)of 62 BPPV associated with VM and 65 primary BPPV patients were conducted from November 2017 to October 2019 at the vertigo clinic research center of our hospital.Results The incidence rates of BPPV associated VM and primary BPPV in men and women were 1∶5.2 and 1∶1.7 respectively,the difference was statistically significant(P<0.05).The number of cases of horizontal affected semicircular canal involved were 25(40.3%)in BPPV associated with VM,15(23.1%)in primary BPPV,the difference was statistically significant(P<0.05).There was no significant difference in the time of repositioning maneuver between BPPV associated with VM and primary BPPV.The abnormity rate of vestibular autorotation test(VAT)was higher in BPPV associated with VM(69.4%)than primary BPPV(52.3%).Conclusion BPPV associated with VM is mainly seen in middle-aged and elderly women,and the horizontal and posterior semicircular canal are easily affected.Vertigo can be controlled in most patients after 1~2 times of repositioning maneuver with 2 to 4 kinds of anti-VM therapy.The abnormal rate of VAT is higher than that of caloric test.

关 键 词：前庭性偏头痛 良性阵发性位置性眩晕 管石复位法 前庭自旋转试验 冷热试验 

分 类 号：R764.34[医药卫生—耳鼻咽喉科]