良性阵发性位置性眩晕的诊断：不同诊断方法的综述。

文献信息

中文摘要

良性阵发性位置性眩晕（BPPV）是患者报告眩晕的最常见原因。BPPV的准确诊断需要高质量的医师培训以及对不同诊断方法优缺点的了解。大多数研究集中于有限数量的诊断方法；本综述的目的是整合并系统化关于现有广泛方法的可用信息。本综述包括对用于诊断BPPV的12种不同技术的临床实用性进行比较描述。BPPV的诊断主要依赖于对临床病史的全面分析以及位置试验（主要是Dix-Hallpike和Pagnini-McClure手法）的专业应用。有几种方法可用于提高位置试验的效率：旋转椅、眼震电图（ENG）、视频眼震图（VNG），以及可能用于分析VNG结果的人工神经网络。VEMP（前庭诱发肌源性电位）技术、前庭冷热试验、视频头脉冲试验、计算机化姿势描记术以及头部CT和MRI都是复杂病例中BPPV鉴别诊断的有用辅助方法。在选择诊断方法时，重要的是要考虑资源与时间消耗和诊断准确性之间的平衡。本综述使人们能够全面而均衡地理解广泛的诊断方法，这对于制定最佳诊断及后续治疗和监测策略是必要的。

英文摘要

Benign paroxysmal positional vertigo (BPPV) is the most common cause of patient-reported vertigo. The accurate diagnosis of BPPV requires high-quality physician training and knowledge of the advantages and disadvantages of different diagnostic methods. Most studies focus on a limited number of diagnostic approaches; the purpose of this review is to consolidate and systematize the available information on the wide range of existing methods. This review includes comparative descriptions of the clinical utility of 12 different techniques used to diagnose BPPV. The diagnosis of BPPV relies primarily on a thorough analysis of clinical history and the professional application of positional tests (primarily the Dix-Hallpike and the Pagnini-McClure maneuvers). Several methods can be used to enhance the efficiency of positional testing: rotary chair, electronystagmography (ENG), videonystagmography (VNG), and potentially artificial neural networks for the analysis of VNG results. The VEMP (vestibular evoked myogenic potential) technique, vestibular caloric testing, the video head impulse test, computerized posturography, and CT and MRI of the head are all useful auxiliary methods for the differential diagnosis of BPPV in complex cases. When selecting diagnostic approaches, it is important to consider the balance between resource and time expenditure and diagnostic accuracy. This review enables a comprehensive and well-rounded understanding of a wide range of diagnostic methods, which is necessary for the development of optimal diagnostic and subsequent treatment and monitoring tactics.