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1、良性阵发性位置性眩晕的眼震图定位诊断王娜I陈太生2林鹏2宋伟2董红21天津医科人学一中心临床学院彳天津市第一中心医院耳鼻咽喉头颈外科；天津市耳鼻喉科研究所(300192)【摘要】目的:探讨眼震图(Videonystagmograph,VNG)対良性阵发性位置性眩晕(BPPV)的定位诊断价值。方法：回顾126例BPPV患者的眼震图资料，分析总结各型BPPV在Dix-Hallpike和滚转试验屮眼震图上的眼震特点。结果：126例BPPV患者屮，后半规管(PSC)BPPV98例(77.8%)、水平半规管(HSC)BPPV17例(13.5%)、前半规管(ASC)BPPV仅5例(3.9%)、混合型BP
2、PV6例(4.8%),28例PSC-BPPV记录到反转相眼震。眼震图上显示PSC和ASC管石症Dix-Hallpike悬头位垂直相眼震分别向上、向下，水平相眼震均向对侧，回到坐位时眼震反向。HSC・BPPV滚转试验向两侧转头均可诱发出眼震，眼震与转头方向相同时，可判断为水平半规管管石症，以能够诱发较强眼震的转头侧为患侧；眼震与转头方向相反时，则为水平半规管皤顶结石症，以能够诱发较弱眼震的转头侧为患侧。结论：眼震图能够客观的记录BPPV患者眼震情况，准确判断耳石所在的半规管，并且保存了眼震数据资料，可以进一步指导临床实践，值得广泛推广。【关键词】视频眼震图；良性阵发性位置性眩晕；半规管；耳石通
3、讯作者：陈太生(cts501@sina.com)PositioningdiagnosisofbenignpositionalparoxysmalvertigobyVNGWangNa1,LinPeng2,ChenTaisheng2,SongWei2,DongHong2('ThefirstcentercliniccollegeofTianjinMedicalUniversity,Tianjin,300192,China;2Otolaryngology-Head&NeckSurgery,TianjinFirstCenterHospital,Tianjin,300192,China)【Abstrac
4、t】ObjectiveToanalyzethevalueofpositioningdiagnosisofVNG(Videonystagmograph)inpatientswithbenignparoxysmalpositionalvertigo(BPPV).Methods126patientswithBPPVwereenrolledinthisretrospectivestudy.TheirpositionalnystagmusrecordedbyVNGinDix・Hallpikeandrolltestswereanalyzedtosummarizethecharacteristicsofn
5、ystagmusonnystagmographofvariousBPPV.ResultsOf126patientswithBPPVdiagnosedinourcenter,theposteriorsemicircularcanals(PSC)wereinvolvedin98patients(77.8%),whereasthehorizontalsemicircularcanal(HSC)andanteriorsemicircularcanal(ASC)wereinvolvedin17(13.5%)and5(3.9%),respectively.6patients(4.8%)confirmed
6、combined-BPPVhadHSC-BPPVandipsilateralPSC-BPPV.28patientswithPSC-BPPVhadreversalphaseonnystagmograph.ThenystagmusofpatientswithP/ASC-canalithiasisshowedupward/downwardontheverticalphaseofnystagmographandorientatedtheoppositesideonhorizontalphaseintheheadhanggingposition,andthenystagmusreversedwhenr
7、eturnedtosit.NystagmusonhorizontalphasecanbeprovokedwhentheheadturnedtobothsidesoftherolltestsinpatientswithHSC-BPPV.Ifthenystagmusandthehead-turningsharedthesamedirection,thenHSC-canalithiasiswasconfirmed,
