180-degree supine roll test

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Lim 2013年报道180°水平滚转试验,认为如果90°水平滚转试验定侧困难,可以使用180°水平滚转试验协助定侧。 提出问题:水平半规管BPPV治疗效果不如后半规管BPPV,其原因之一是定侧困难。90°水平滚准试验,部分患者很难判断哪一侧眼震比较强烈,

122位HSP-BPPV患者同时使用90°水平滚准试验和180°水平滚转试验,定位困难者加做bow and lean试验。

说明

   Lim等认为头转动幅度越大,诱发眼震越明显。
   The 180-degree SRT (D, E, and F) was performed after the 90-degree SRT (A, B, and C). The magnified right lateral semicircular canal was described according to the head position and shows otolith locations, gravitation forces, endolymph flow, and cupula deflection. Geo indicates geotropic type; Apogeo, apogeotropic type.


分析: 国内李氏提出用快速180°翻身治疗水平半规管BPPV疗效高达180°,所以上述诊断试验顺序就显得非常重要了。可以确定,翻身可能是的耳石复位。如果180°水平滚转试验在前,可能部分患者已经治愈,那么90°水平滚转试验的阳性率就有问题了。原文所述“We performed the 90- and 180-degree SRTs sequentially”,也就是先做90°水平滚转试验,再做180°水平滚转试验。 还有一点非常有意思,“Among the 122 patients with HSCBPPV,67 cases were the geotropic type (54.9%), and 55 cases were the apogeotropic type (45.1%)”,背地眼震比例很高。

水平半规管BPPV患者中,背地眼震比例大概是多少?



参考文献: [1] Lim H J, Park K, Park H Y, et al. The significance of 180-degree head rotation in supine roll test for horizontal canal benign paroxysmal positional vertigo[J]. Otology & Neurotology, 2013, 34(4):736-742.