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2I天津医科大学一中心临床学院2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:探讨眼鳶图(Videonystagmograph,VNG)对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和滚转试验中眼震图上的眼震特点。结果：126例BPPV患者中，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%)、混介型BPPV6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悬头位垂靑相眼震分别向上、向下，水平相眼震均向对侧，回到朋位时眼震反向。HSC-BPPV滚转试验向两侧转头均门J诱发岀眼震，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，则为水平半规管悄顶结石症，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；耳石通讯作者：陈太生(cts501@sina.com)PositioningdiagnosisofbenignpositionalparoxysmalvertigobyVNGWangNa1,LinPeng2,ChenTaisheng2,SongWei2,DongHong2('ThefirstcentercliniccollegeofTianjinMedicalUniversity,Tianjin,300192,China;^Otolaryngology-Head&NeckSurgery,TianjinFirstCenterHospital,Tianjin,300192,China)【Abstract]ObjectiveToanalyzethevalueofpositioningdiagnosisofVNG(Videonystagmograph)inpatientswithbenignparoxysmalpositionalvertigo(BPPV).Methods126patientswithBPPVwereenrolledinthisretrospectivestudy・TheirpositionalnystagmusrecordedbyVNGinDix-HallpikeandrolltestswereanalyzedtosummarizethecharacteristicsofnystagmusonnystagmographofvariousBPPV.ResultsOf126patientswithBPPVdiagnosedinourcenter,theposteriorsemicircularcanals(PSC)wereinvolvedin98patients(77.8%),whereasthehorizontalsemicircularcanal(HSC)andanteriorsemicircularcanal(ASC)wereinvolvedin17(13.5%)and5(3.9%),respectively.6patients(4.8%)confirmedcombined-BPPVhadHSC-BPPVandipsilateralPSC-BPPV.28patientswithPSC-BPPVhadreversalphaseonnystagmograph.ThenystagmusofpatientswithP/ASC-canalithiasisshowedupward/downwardontheverticalphaseofnystagmographandorientatedtheoppositesideonhorizontalphaseintheheadhanggingposition,andthenystagmusreversedwhenreturnedtosit.NystagmusonhorizontalphasecanbeprovokedwhentheheadturnedtobothsidesoftherolltestsinpatientswithHSC-BPPV.Ifthenystagmusandthehead-turningsharedthesamedirection,thenHSC-canalithiasiswasconfirmed,andthedirectionofthehead-turningwhichprovokedthestrongernystagmusindicatesthelesionside.Ifthenystagmusandthehead-turninghadtheoppositedirection,thenHSC-cupulolithiasiswasconfirmed,andthedirectionofthehead-turningwhichprovokedtheweakernystagmusindicatesthelesionside・ConclusionPositionalnystagmuscanberecordedobjectivelyusingVNG.Positioningthesemicircularcanalinvolvedwillbeeasierandmoreaccurateaccordingtoit.TherecordingconservedalsobehelpfulforclinicaldiagnosisandrepositioningofBPPV.【Keywords]Videonystagmograph(VNG)；benignpositionalparoxysmalvertigo(BPPV)；semicircularcanal；otolithCorrespondingauthor:ChenTaisheng(cts501@sina.com)良性阵发性位置性眩晕(benignpositionalparoxysmalvertigo,BPPV)是头部运动到某一特定位置时诱发的短暂眩晕，是一种具有口限性的周围性前庭疾病山。该病发病率较高，约占所有周围性眩晕的17%〜20%l2J0BPPV耳石复位治疗技术已经成熟，成功复位治疗的基础是对耳石累及半规管的准确定位。...