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目的:观察及评价坐-卧位眼震(SSPN)在良性阵发性位置性眩晕(BPPV)诊断中的意义。方法:收集200例诊断为BPPV的病例,所有病例先行坐-卧位试验观察SSPN,再行滚转试验及Dix-Hallpike试验。依据滚转试验、Dix-Hallpike试验确定BPPV类型并分组,统计分析不同类型BPPV的SSPN诱发率及特征。结果:200例BPPV患者中116例(58.0%)诱发出SSPN,其中PSC-BPPV组(136例)中72例诱发出SSPN,HSC-BPPV组(60例)中44例诱发出SSPN,ASC-BPPV组(4例)中无SSPN。PSC-BPPV组诱发出的SSPN均表现为以眼球上极为标志的、扭转成分向患侧、垂直成分向额侧的垂直扭转性眼震。管石型HSC-BPPV患者(41例)中28例诱发出SSPN,其中22例诱发出的SSPN指向健侧,6例诱发出的SSPN指向患侧;嵴顶结石型HSC-BPPV患者(19例)中16例诱发出SSPN,诱发出的SSPN均指向患侧。结论:SSPN对不同类型BPPV的诊断意义不同,可结合SSPN对BPPV诊断。
Objective: To observe and evaluate the significance of sit-lying position nystagmus (SSPN) in the diagnosis of benign paroxysmal positional vertigo (BPPV). Methods: 200 cases diagnosed as BPPV were collected. SSPN was first observed in all cases by sit-and-lie test, followed by rolling test and Dix-Hallpike test. According to the roll test, Dix-Hallpike test to determine the type of BPPV and grouping, statistical analysis of different types of BPPV SSPN induced rate and characteristics. RESULTS: SSPN was induced in 116 of 200 (58.0%) BPPV patients, of which SSPN was induced in 72 of PSC-BPPV (136 patients) and SSPN in 44 of HSC-BPPV (60 patients) There was no SSPN in BPPV group (4 cases). The SSPNs induced by PSC-BPPV group showed vertical twisted nystagmus with the most prominent eyeballs and the twisting component to the affected side and the vertical component to the frontal side. SSPN was induced in 28 of 40 patients with ductal HSC-BPPV (n = 28). SSPN was induced in 22 patients with SSPN and ipsilateral to the ipsilateral SSPN in 6 patients (19 patients with crest-stone type HSC-BPPV ), 16 cases of SSPN induced SSPN were induced to the affected side. Conclusion: SSPN is of different significance in diagnosis of different types of BPPV, and can be used to diagnose BPPV in combination with SSPN.