首页> 美国卫生研究院文献>International Archives of Otorhinolaryngology >Identification of Factors Related to Cases of Benign Paroxysmal Positional Vertigo Refractory to Canalicular Repositioning Maneuvers and Evaluation of the Need for Magnetic Resonance Imaging in their Management: Retrospective Analysis of a Series of 176 Cases
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Identification of Factors Related to Cases of Benign Paroxysmal Positional Vertigo Refractory to Canalicular Repositioning Maneuvers and Evaluation of the Need for Magnetic Resonance Imaging in their Management: Retrospective Analysis of a Series of 176 Cases

机译:确定与良性阵发性位置性眩晕难治性小管再定位术病例相关的因素并评估其管理中磁共振成像的必要性:176例病例的回顾性分析

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摘要

>Introduction  Benign paroxysmal positional vertigo (BPPV) is the most common form of peripheral vertigo, and, in most cases, it presents a favorable prognosis. The treatment is based on a series of specific canalicular repositioning maneuvers that offer an efficacy close to 100%. Despite this, there are cases that are refractory to treatment, with the persistence of the vertigo symptoms. >Objectives  The objective of the present paper is to analyze the factors associated with an increased risk of refractory BPPV and the importance of nuclear magnetic resonance in the study of these patients. >Methods  We retrospectively reviewed the cases of 176 patients diagnosed with BPPV in our center. We divided them into two groups: responders and non-responders to the treatment, and analyzed the possible risk factors associated with a higher risk of refractory vertigo. Fischer exact test was used. >Results  We found 11 cases refractory to treatment; all of them underwent magnetic resonance imaging (MRI) with gadolinium according to our protocol. Of these, four had an otoneurologic background or pathology, and two other patients presented a multicanal involvement. The difference between the two groups was statistically significant ( p  < 0.05). >Conclusion  Otoneurologic background and multicanal involvement were associated with a higher risk of refractory BPPV. When dealing with a BPPV with persistent symptomatologyystagmus or with early relapse after an initial improvement, other entities that enter into the differential diagnosis must always be considered. We consider it essential to perform an MRI with gadolinium to rule out cases of BPPV that have a central cause.
机译:>简介良性阵发性位置性眩晕(BPPV)是周围性眩晕的最常见形式,在大多数情况下,其预后良好。该治疗基于一系列特定的小管再定位操作,可提供接近100%的功效。尽管如此,仍有一些难以治愈的病例,并伴有眩晕症状。 >目的本文的目的是分析与难治性BPPV风险增加相关的因素以及核磁共振在这些患者研究中的重要性。 >方法我们回顾性分析了我中心诊断为BPPV的176例患者的病例。我们将其分为两组:对治疗有反应者和无反应者,并分析了与难治性眩晕风险较高相关的可能危险因素。使用Fischer精确测试。 >结果我们发现有11例患者难以治疗;根据我们的方案,所有患者均接受了with的磁共振成像(MRI)。其中,四人具有耳科背景或病理学特征,另外两名患者表现为多管侵犯。两组之间的差异具有统计学意义(p <0.05)。 >结论耳鼻喉科背景和多管受累与难治性BPPV的风险较高相关。当治疗伴有持续症状/眼球震颤或初次改善后早期复发的BPPV时,必须始终考虑进行鉴别诊断的其他实体。我们认为用with进行MRI以排除具有中心原因的BPPV病例至关重要。

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