论文部分内容阅读
目的探讨眩晕患者的病因、病变部位及前庭功能检测的特点。方法对2001~2002年我院门诊病房共计150例眩晕患者行纯音测听、声导抗、听性脑干反应(ABR)、耳蜗电图、眼震电图(ENG)、颅脑CT、颈部动脉多普勒超声检查等,并对结果进行分析。结果诊断为梅尼埃病30例,占20%,突发性聋伴眩晕19例,占12.7%,前庭神经炎4例,占2.7%,耳毒性药物中毒10例,占6.7%,良性阵发性位置性眩晕56例,占37.3%,听神经瘤1例,椎-基底动脉供血不足25例,占16.6%,脑供血不足5例,占3.3%。中枢性眩晕31例患者ENG显示眼辩障碍试验有过冲20例,自发性眼震18例,视动性眼震试验双侧不对称25例,视跟踪试验Ⅲ型曲线6例,双温试验轻瘫2例,麻痹15例。周围性眩晕119例患者ENG结果显示眼辩障碍试验有过冲42例,自发性眼震4例,视动性眼震34例,视跟踪试验I型曲线80例,双温试验轻瘫42例。结论本组150例眩晕患者中,周围性眩晕发病率比中枢性高。周围性眩晕患者中纯音测听高频听力下降为主,ABR正常。中枢性眩晕患者中高刺激率听性脑干反应异常对听神经瘤有一定的诊断价值。中枢性眩晕患者双温试验异常率低,而周围性眩晕患者异常率偏高,说明迷路病变与周围性眩晕发病有关。
Objective To investigate the etiology, lesion site and vestibular function of vertigo patients. Methods A total of 150 patients with vertigo in outpatient ward of our hospital from 2001 to 2002 underwent pure tone audiometry, acoustic impedance, auditory brainstem response (ABR), electrocochleogram, electronystagmography (ENG), brain CT, Department of artery Doppler ultrasound examination, and the results were analyzed. Results The diagnosis of Meniere’s disease in 30 cases, accounting for 20%, sudden deafness with vertigo in 19 cases, accounting for 12.7%, 4 cases of vestibular neuritis, accounting for 2.7%, ototoxic drugs poisoning in 10 cases, accounting for 6.7%, benign 56 cases of paroxysmal positional vertigo (37.3%), acoustic neuroma in 1 case, vertebrobasilar artery insufficiency in 25 cases (16.6%), cerebral insufficiency in 5 cases (3.3%). In the 31 patients with central vertigo, there were 20 cases of overshoot in ENG test, 18 cases of spontaneous nystagmus, 25 cases of bilateral asymmetry of optokinetic nystagmus, 6 cases of type III curve in visual follow-up test, 2 cases of paralysis, 15 cases of paralysis. Results of ENG in 119 patients with peripheral vertigo showed that there were 42 cases of ophthalmoplegia test with overshooting, 4 cases of spontaneous nystagmus, 34 cases of optokinetic nystagmus, 80 cases of type I curve of visual follow-up test, 42 cases of bipolar disorder . Conclusion 150 patients with vertigo in this group, the incidence of peripheral vertigo than the central high. In patients with peripheral vertigo audiometry audiometry hearing loss mainly ABR normal. Central vertigo in patients with high stimulation of abnormal auditory brainstem response of acoustic neuroma have a certain diagnostic value. In patients with central vertigo, the abnormal rate of dual-temperature test is low, while the abnormal rate of patients with peripheral vertigo is high, indicating that the pathological changes of the lost vertigo are related to the incidence of peripheral vertigo.