When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

良性阵发性位置性眩晕

最后审阅: 6 Oct 2024
最后更新: 28 Sep 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 特定的诱发体位
  • 眩晕持续时间短
  • 阵发性眩晕
  • 眩晕重度发作
  • 眩晕突然发作
  • 恶心、平衡失调和头晕
  • 没有相关的神经病学或耳科症状
  • 神经系统体格检查正常
  • Dix-Hallpike检查阳性或仰卧侧向转头检查阳性
  • 耳科检查正常
完整详情

其他诊断因素

  • 年龄>50 岁
  • 女性
  • 无眼球震颤的位置性眩晕
完整详情

危险因素

  • 年龄增长
  • 女性
  • 头部外伤
  • 前庭神经元炎
  • 迷路炎
  • 偏头痛
  • 内耳手术
  • 梅尼埃病
  • 中耳炎
  • 高血压
  • 高甘油三酯血症
  • 糖尿病
  • 椎基底动脉供血不足
  • 巨细胞性动脉炎
  • 骨质疏松症
  • 插管
  • 在卧床休息时习惯性的侧头姿势(同侧BPPV)
完整详情

诊断性检查

首要检查

  • Dix-Hallpike 试验
  • 仰卧侧向转头检查
完整详情

需考虑的检查

  • 听力敏度图
  • 脑部 MRI
完整详情

治疗流程

急症处理

初期表现

持续性治疗

多次复位操作和前庭康复训练无效

撰稿人

作者

Lorne S. Parnes, MD, FRCSC
Lorne S. Parnes

Professor

Departments of Otolaryngology-Head and Neck Surgery and Clinical Neurological Sciences

University of Western Ontario

London

Canada

利益声明

LSP is an author of a number of references cited in this topic.

Shahin Nabi, MD, FRCSC
Shahin Nabi

Departments of Otolaryngology-Head and Neck Surgery and Clinical Neurological Sciences

University of Western Ontario

London

Canada

利益声明

SN declares that he has no competing interests.

同行评议者

Joel Goebel, MD, FACS

Professor and Vice Chairman

Residency Program Director

Dizziness and Balance Center Director

Otolaryngology-Head and Neck Surgery

Washington University School of Medicine

St. Louis

MO

利益声明

JG is an author of a number of references cited in this topic.

Stephen P. Cass, MD

Associate Professor

Department of Otolaryngology

University of Colorado

Aurora

CO

利益声明

SPC is an author of a number of references cited in this topic.

Steven D. Rauch, MD

Associate Professor of Otology and Laryngology

Harvard Medical School

Boston

MA

利益声明

SDR declares that he has no competing interests.

Malcolm Hilton, BA, BMBCh, FRCS (Eng), FRCS (ORL-HNS)

Consultant Otolaryngologist & Honorary Lecturer

Royal Devon & Exeter NHS Foundation Trust

Exeter

UK

利益声明

MH is the author of one reference cited in this topic.

内容使用需遵循免责声明