中国北方人群70例前庭阵发症临床特点分析  

Clinical characteristics of vestibular paroxysmia in a northern Chinese cohort of 70 patients

作　　者：樊春秋[1] 刘静[1] 黄小钦[1] 杨冬菊[1] 陈芳[1] 户宁宁 刘爱华[1] FAN Chunqiu;LIU Jing;HUANG Xiaoqin(Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院神经内科,北京100053

出　　处：《中风与神经疾病杂志》2023年第11期996-999,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的阐述VP的年龄分布、诱因、伴随症状、单日最多发作次数、发作时眼震特点和神经血管关系。方法收集70例VP患者的临床资料,主要对年龄分布、发作特点(诱因、伴随症状和单日最多发作次数)、发作时眼震特点和神经血管关系几个方面进行分析,应用描述统计方法,对数据进行分析。结果70例VP患者中30例为老年患者(42.86%),23例为青年患者(32.86%),17例为中年患者(24.29%);53例(75.71%)单日最多发作次数在2~5次之间,9例(12.86%)在6~10次之间,8例(11.43%)大于10次;36例患者(51.43%)存在诱因,包括快速行走、情绪激动、开车、骑车、性交、咳嗽或喘息、演讲或聊天、洗澡、大便、饮酒和声音刺激;33例患者(47.14%)眩晕发作伴有单侧耳鸣、头鸣和双耳鸣,耳鸣伴面肌痉挛;发作时眼震符合头坐标系眼震特点:朝向患侧水平伴旋转眼震;57例患者行MRA(前庭蜗神经与血管关系)检查,37例(64.91%)右侧小脑前下动脉与前庭蜗神经比邻,15例(26.32%)左侧小脑前下动脉与前庭蜗神经比邻,5例(8.77%)基底动脉与前庭蜗神经比邻。结论VP老年多见,青年次之,中年最低;大多数VP患者单日最多发作次数在2~5次之间;情绪激动、兴奋和运动等可诱发VP发作;VP发作时眩晕同时可伴有耳鸣、头鸣和面肌痉挛;VP发作期表现朝向患侧的水平伴旋转眼震;右侧小脑前下动脉与前庭蜗神经比邻在VP患者中比例最高。Objective To investigate the clinical characteristics of vestibular paroxysmia(VP):age distribution,triggers,accompanying symptoms,maximum frequency per day,nystagmus features during attacks,and neurovascular compression.Methods The clinical data of 70 patients with VP were collected to analyze their age distribution,triggers,accompanying symptoms,maximum frequency per day,nystagmus features during attacks,and neurovascular compression by using descriptive statistical methods.Results Among the 70 patients with VP,30(42.86%)were elderly,23(32.86%)were young,and 17(24.29%)were middle-aged patients.The maximum frequency per day was 2-5 in 53 cases(75.71%),6-10 in 9 cases(12.86%),and>10 in 8 cases(11.43%).Thirty-six patients(51.43%)had triggers,including rapid walking,emotional excitement,driving,cycling,sexual intercourse,coughing or wheezing,speaking or chatting,bathing,defecation,drinking alcohol,and sound stimulation.Thirty-three patients(47.14%)had unilateral tinnitus,bilateral tinnitus,and tinnitus with facial spasms;nystagmus during VP episodes met the characteristics of the head coordinate system,which was horizontal-torsional towards the affected side.Among 57 patients examined for the relationship between the vestibulocochlear nerve and vessels using magnetic resonance angiography,37 patients(64.91%)had contact between the vestibulocochlear nerve and the right anterior inferior cerebellar artery,15 patients(26.32%)had contact between the vestibulocochlear nerve and the left anterior inferior cerebellar artery,and 5 patients(8.77%)had contact between the vestibulocochlear nerve and the basilar artery.Conclusion VP is most prevalent in the elderly,then young and middle-aged people.Most patients with VP have a maximum frequency of 2-5 per day.VP can be triggered by anger,excitement,exercise,and various stimuli.VP attacks can be accompanied by tinnitus and facial spasms.Its nystagmus is horizontal-torsional towards the affected side.The percentage of contact between the vestibulocochlear nerve and the right ant

关 键 词：前庭阵发症 诱因 伴随症状 单日最多发作次数 眼震 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]