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
其他诊断因素
- 年龄＞50 岁
- 女性
- 无眼球震颤的位置性眩晕
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）
诊断性检查
首要检查
- Dix-Hallpike 试验
- 仰卧侧向转头检查
需考虑的检查
- 听力敏度图
- 脑部 MRI
治疗流程
初期表现
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
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
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.
鉴别诊断
- 梅尼埃病
- 前庭神经元炎
- 迷路炎
更多 鉴别诊断指南
- ACR 适宜性标准：头晕和共济失调
- 临床实践指南：良性阵发性位置性眩晕（更新）
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良性阵发性位置性眩晕
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