老年特发性良性阵发性体位性眩晕复位成功后的残留头晕

Menna-Allah Mohamed, N. Ismail, Hesham Sami
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摘要

背景良性阵发性位置性眩晕(BPPV)是一种平衡障碍,对重新定位动作的反应最为明显;然而,一些患者报告在一段时间后,不平衡无位置性眩晕,称为残余头晕(RD)。这种不平衡通常被描述为在没有眩晕或眼球震颤的情况下感到头晕或头晕,或在头部运动、站立或行走时出现短暂的不稳定。目的探讨老年BPPV复位成功后发生RD的可能因素。患者与方法本研究对100例复位成功后出现RD的患者进行了研究;他们的年龄不低于60岁。本研究于2017年11月至2019年3月在Minia大学医院耳鼻喉科听庭单元完成,经伦理委员会批准,所有患者在纳入研究前均给予知情同意。收集任何RD的特征和持续时间的数据,并使用专门的计算机统计程序分析与RD相关的临床因素。结果研究显示,RD与高血压、糖尿病、焦虑、抑郁、白内障、骨质疏松、耳鸣、维生素D缺乏症、关节痛、偏头痛、心脏病、贫血、青光眼、肺炎、多神经病变等全身性疾病存在显著相关性。结论老年BPPV患者复位成功后发生RD的风险因多种因素而增加,需要快速诊断,以避免患者因不稳定而发生跌倒和焦虑的风险。
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Residual dizziness after successful repositioning maneuvers for idiopathic benign paroxysmal positional vertigo in the elderly
Background The benign paroxysmal positional vertigo (BPPV) is a balance disorder with the most brilliant response to repositioning maneuvers; nevertheless, some patients report for a certain period afterward, imbalance without positional vertigo, named residual dizziness (RD). This imbalance is often described as a sensation of lightheadedness or dizziness in absence of vertigo or nystagmus, or short-lasting unsteadiness occurring during head movements, standing, or walking. Aim To evaluate the possible factors involved in RD after successful repositioning maneuvers for BPPV in the elderly. Patients and methods This study was done on 100 patients complaining of RD after successful repositioning maneuver; their ages were not less than 60 years old. The study was done during the period from November 2017 to march 2019 at the audiovestibular unit of ENT Department at Minia University Hospital and approved by the Ethics Committee, and all patients gave their informed consent before inclusion in the study. Data were collected on the characteristics and duration of any RD, and the clinical factors associated with the RD were analyzed using a specialized computer statistical program. Results The study showed that there were significant relationships between RD and other systemic diseases such as uncontrolled hypertension, uncontrolled diabetes, anxiety, depression, cataract, osteoporosis, tinnitus, vitamin D deficiency, joint pain, migraine, heart diseases, anemia, glaucoma, pneumonia, and polyneuropathy. Conclusion There is increased risk of RD after successful repositioning maneuvers in elderly patients with BPPV owing to many factors, and fast diagnosis is desirable to avoid risk of falls and anxiety related to unsteadiness in these patients.
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