Epley手法后后半规管BPPV转换为水平半规管BPPV
Conversion of posterior canal BPPV to lateral canal BPPV following the Epley maneuver.
文献信息
| PMID | 42869725 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Q Legois |
| 作者单位 | ORL, Otoneurology and ORL Pediatric Department, CHU Toulouse, Toulouse, France; UMR5549, CNRS, Brain and Cognition Research Center, Toulouse, France. Electronic address: legois.q.prestataire-externe@chu-toulouse.fr. |
| 期刊 | European annals of otorhinolaryngology, head and neck diseases |
| SCI 分区 | Q2 |
| IF | 1.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
引言： 良性阵发性位置性眩晕（BPPV）由半规管内自由漂浮的耳石引起。后半规管最常受累，水平半规管和上半规管较少见。半规管特异性复位手法可有效治疗BPPV，但耳石可在半规管之间迁移，导致“转换综合征”。
病例总结： 一名56岁女性左侧后半规管BPPV患者接受了Epley手法。立即复测显示转换为左侧水平半规管BPPV，经Baloh-Lempert手法成功治疗。一周随访时，位置试验正常且无症状。本病例附有视频说明。
讨论： 从后半规管向水平或上半规管BPPV的转换虽不常见，但说明了耳石的可变行为以及手法动力学的影响。识别沉降速度、最佳复测时机和手法类型等因素可改善管理并降低半规管转换的风险。
英文摘要
INTRODUCTION: Benign paroxysmal positional vertigo (BPPV) is caused by freely floating otoconia in the semicircular canals. The posterior canal is the most affected, with the lateral and superior canals less frequently. Canal-specific repositioning maneuvers effectively treat BPPV, but otoconia can migrate between canals, causing "conversion syndrome".
CASE SUMMARY: A 56-year-old woman with left posterior canal BPPV underwent an Epley maneuver. Immediate retesting revealed conversion to left lateral canal BPPV, which was successfully treated with a Baloh-Lempert maneuver. At one-week follow-up, positional tests were normal and she was asymptomatic. This case is illustrated in the accompanying video.
DISCUSSION: Conversion from posterior to lateral or superior canal BPPV, while uncommon, illustrates the variable behavior of otoconia and the impact of maneuver dynamics. Identifying factors such as sedimentation speed, optimal retest timing, and maneuver type could improve management and reduce the risk of canal conversion.