中国临床医学2025，Vol.32Issue(2)：177-182,6.DOI:10.12025/j.issn.1008-6358.2025.20250222
良性阵发性位置性眩晕患者三维视频眼震图特征分析
Three-dimensional videonystagmography characteristics in patients with benign paroxysmal positional vertigo
摘要
Abstract
Objective To analyze the characteristics of nystagmus during the Dix-Hallpike and Roll tests in patients with benign paroxysmal positional vertigo(BPPV)using three-dimensional videonystagmography(3D-VNG),in order to to optimize diagnostic and therapeutic strategies of BPPV.Methods A retrospective analysis was conducted on 68 patients with posterior semicircular canal(PSC)-BPPV and 26 patients with horizontal semicircular canal(HSC)-BPPV.Nystagmus data obtained from 3D-VNG were reviewed for all patients,with a focus on the eye movement components during the Dix-Hallpike test in PSC-BPPV patients and the Roll test in HSC-BPPV patients.The direction and reversal rates of the vertical,horizontal,and torsional components were recorded and analyzed.Results All PSC-BPPV patients exhibited highly consistent three-dimensional nystagmus characteristics during the Dix-Hallpike test:vertical nystagmus was uniformly upward,torsional nystagmus was predominantly clockwise in left-side BPPV patients(17/23)and counterclockwise in right-side BPPV patients(44/45),while the horizontal component was mostly directed contralaterally(50/68);upon transitioning from the head-hanging to the sit-up position,vertical nystagmus components in all patients reversed,and torsional and horizontal nystagmus components reversed in approximately 50.0%or more patients.Among HSC-BPPV patients,right-side BPPV patients all showed right-beating(geotropic)horizontal nystagmus with predominantly upward vertical component(16/19),while most left-side BPPV patients showed left-beating horizontal nystagmus(6/7)with predominantly downward vertical component(6/7).During head rotation toward the healthy side,most(25/26)HSC-BPPV patients exhibited a reversal in the horizontal nystagmus direction,reduced intensity compared to the affected side,with a reversal in vertical components in 3 patients,and atypical torsional components.Conclusions 3D-VNG could precisely quantitative analyze three-dimensional features of nystagmus in BPPV patients,improve diagnostic accuracy in canal and side localization,particularly in PSC-BPPV patients.关键词
三维视频眼震图/良性阵发性位置性眩晕/后半规管/水平半规管Key words
three-dimensional videonystagmography/benign paroxysmal positional vertigo/posterior semicircular canal/horizontal semicircular canal分类
临床医学引用本文复制引用
郑育金,陈克光,蒋康伦,徐枫,戚颖,黄新生,蒋怀礼..良性阵发性位置性眩晕患者三维视频眼震图特征分析[J].中国临床医学,2025,32(2):177-182,6.基金项目
国家重点研发计划"常见多发病防治研究"重点专项(2023YFC2508000/8005).Supported by"Common Disease Prevention and Control Research"Key Project of National Key R&D Program of China(2023YFC2508000/8005). （2023YFC2508000/8005）
