良性阵发性位置性眩晕的单中心临床分析
A single-center clinical analysis of benign paroxysmal positional vertigo
Received date: 2025-06-05
Online published: 2025-09-05
目的 分析良性阵发性位置性眩晕(benign paroxysmal positional vertigo, BPPV)的临床特征。方法 选取2021年2月-2024年11月华侨大学附属厦门长庚医院神经内科门诊收治的BPPV患者339例,并回顾性分析其临床特征。结果 男性138例(40.7%),女性201例(59.3%),男女比例为1∶1.5。平均年龄(49.6±6.5)岁。发病高峰年龄为40~49岁。155例(45.7%)既往有类似发作。后半规管BPPV 210例(61.9%);水平半规管BPPV 118例(34.8%),其中水平半规管管结石型91例(77.1%),嵴帽结石型27例(22.9%)。手法复位总有效率99.6%。210例有随访资料,随访时间1~33个月,复发45例,复发率21.4%。结论 BPPV发病年龄有年轻化趋势;受累半规管类型以后半规管BPPV居多;BPPV的手法复位效果显著。
关键词： 良性阵发性位置性眩晕; 临床分型; 手法复位
邹亚芬 , 贾晓燕 , 戴翠招 . 良性阵发性位置性眩晕的单中心临床分析[J]. 临床荟萃, 2025 , 40(8) : 694 -697 . DOI: 10.3969/j.issn.1004-583X.2025.08.004
Objective To analyze the clinical features of benign paroxysmal positional vertigo (BPPV). Methods From February 2021 to November 2024, 339 BPPV patients diagnosed and treated in the Department of Neurology, Xiamen Chang Gung Hospital, Huaqiao University, were selected as the subjects. The clinical data were analyzed retrospectively. Results There were 138 (40.7%) males and 201 (59.3%) females, with the male-to-female ratio of 1∶1.5. The mean age was 49.6±6.5 years. A total of 155 patients (45.7%) had similar attacks in the past. The peak age of onset was 40-49 years. Classified by the clinical types, there were 210 (61.9%) cases of posterior semicircular canal BPPV, and 118 (34.8%) cases of horizontal semicircular canal BPPV, including canalolithiatic type in 91 (77.1%) cases and cupulolithiatic in 27 (22.9%) cases. The overall effectiveness rate of canalith repositioning maneuver was 99.6%. Among the 210 cases with follow-up data, the follow-up period ranged from 1 to 33 months. There were 45 cases of recurrence, with the recurrence rate of 21.4%. Conclusion The age of BPPV onset is trending younger. Posterior semicircular canal BPPV is the most common clinical type. The effectiveness rate of canalith repositioning maneuver of BPPV is high.
| [1] | Imai T, Inohara H. Benign paroxysmal positional vertigo[J]. Auris Nasus Larynx, 2022, 49(5):737-747. |
| [2] | Von Brevern M, Radtke A, Lezius F, et al. Epidemiology of benign paroxysmal positional vertigo: A population based study[J]. J Neurol Neurosurg Psychiatry, 2007, 78(7):710-715. |
| [3] | Kim HJ, Lee JO, Choi JY, et al. Etiologic distribution of dizziness and vertigo in a referral-based dizziness clinic in South Korea[J]. J Neurol, 2020, 267(8):2252-2259. |
| [4] | Wang YL, Wu MY, Cheng PL, et al. Analysis of cost and effectiveness of treatment in benign paroxysmal positional vertigo[J]. Chin Med J (Engl), 2019, 132(3):342-345. |
| [5] | 孔维佳. 良性阵发性位置性眩晕诊断和治疗指南[J]. 中华耳鼻喉头颈外科杂志, 2017, 52(3):173-177. |
| [6] | Kim MK, Kim HJ, Choi JY, et al. Clinical features and outcome predictors in benign paroxysmal positional vertigo and its variant: Perspective in a primary care neurology clinic[J]. J Vestib Res, 2025:9574271251347261. |
| [7] | Bhandari R, Bhandari A, Hsieh YH, et al. Prevalence of horizontal canal variant in 3, 975 patients with benign paroxysmal positional vertigo: A cross-sectional study[J]. Neurol Clin Pract, 2023, 13 (5): e200191-e200196. |
| [8] | 李玉娟, 刘鹏. 不同性别良性阵发性位置性眩晕患者临床特征分析[J]. 神经损伤与功能重建, 2019, 14(3):156-158. |
| [9] | Song N, Wu Y, Li X, et al. Geriatric benign paroxysmal positional vertigo: A single-center study[J]. Braz J Otorhinolaryngol, 2023, 89(4): 101277-101284. |
| [10] | 李婷婷, 葛槟华. 801例良性阵发性位置性眩晕患者的临床特点及残余症状影响因素分析[J]. 卒中与神经疾病, 2024, 31(5):476-481. |
| [11] | 吴军, 李伊, 黄远贞. 青年人良性阵发性位置性眩晕的危险因素分析[J]. 深圳中西医结合杂志, 2019, 29(11):163-164. |
| [12] | Yousovich R, Duvdevani SI, Lipschitz N, et al. Correlation between the sleep-position habits and the affected posterior semicircular canal in patients with benign paroxysmal positional vertigo[J]. Isr Med Assoc J, 2019, 21(11):716-718. |
| [13] | Von Brevern M, Seelig T, Radtke A, et al. Short-term efficacy of Epley's maneuver: A double-blind randomised trial[J]. J Neurol Neurosurg Psychiatry, 2006, 77(8):980-982. |
| [14] | Gordon CR, Gadoth N. Repeated vs single physical maneuver in benign paroxysmal positional vertigo[J]. Acta Neurol Scand, 2004, 110(3):166-169. |
| [15] | Casani AP, Gufoni M. Recurring benign paroxysmal positional vertigo after successful canalith repositioning maneuvers[J]. Acta Otorhinolaryngol Ital, 2023, 43(Suppl 1): S61-S66. |
| [16] | Evans A, Frost K, Wood E, et al. Management of recurrent benign paroxysmal positional vertigo[J]. J Laryngol Otol, 2024, 138(S2): S18-S21. |
| [17] | Teggi R, Guidetti R, Gatti O, et al. Recurrence of benign paroxysmal positional vertigo: Experience in 3042 patients[J]. Acta Otorhinolaryngol Ital, 2021, 41(5):461-466. |
| [18] | Chen J, Zhang S, Cui K, et al. Risk factors for benign paroxysmal positional vertigo recurrence: A systematic review and meta-analysis[J]. J Neurol, 2021, 268(11):4117-4127. |
| [19] | 朱希恩, 焉双梅, 顾平. 维生素D与良性阵发性位置性眩晕及残余头晕关系的研究进展[J]. 中风与神经疾病杂志, 2025, 42(6):568-572. |
| [20] | Song P, Zhao X, Xu Y, et al. Correlation between benign paroxysmal positional vertigo and 25-hydroxyvitamin D[J]. Front Neurol, 2020, 11:576-583. |
| [21] | Jeong SH, Kim JS, Kim HJ, et al. Prevention of benign paroxysmal positional vertigo with Vit D supplementation: A randomized trial[J]. Neurology, 2020, 95(9): e1117-e1125. |
| [22] | Rhim G, Kim MJ. Vitamin D supplementation and recurrence of benign paroxysmal positional vertigo[J]. Nutrients, 2024, 16(5):689-699. |
| [23] | Hong X, Christ-Franco M, Moher D, et al. Vitamin D supplementation for benign paroxysmal positional vertigo: A systematic review[J]. Otol Neurotol, 2022, 43(7):e704-e711. |
| [24] | Karata? A, Acar Yüceant G, Yüce T, et al. Association of benign paroxysmal positional vertigo with osteoporosis and vitamin D deficiency: A case controlled study[J]. J Int Adv Otol, 2017, 13(2):259-265. |
| [25] | Wood H, Kluk K, BinKhamis G. Association between vitamin D deficiency and benign paroxysmal positional vertigo (BPPV) incidence and recurrence: A systematic review and meta-analysis[J]. BMJ Open. 2024, 14(4):e077986-e077997. |
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