BPPV良性发作性位置性眩晕PPT课件

BENIGN PAROXYSMAL POSITIONAL VERTIGO,Basic Anatomy,BPPV,Barany 1921Dix-Hallpike 1952 important features of nystagmus Abnormal sensation of motion elicited by certain critical positionsProvocative position nystagmusAt least 20% of vertigoUnderestimated,BPPV ,Pathophysiology :Canalithiasiscupulolithiasis,Pathophysiology (cont.),Cupulolithiasis : Harold Schuknecht 1962 Densities (otocania) adherent to cupula of crista ampullarisBasophilic particles -1969,Canalithiasis :John Epley 1980Densities free floating in canal portionParnes , McClure 1991 found particles in post SCC,Pathophysiology,BPPV .,Frequency : 10-64/100000Sex : 64% womenAge : older population ( 51-57) younger than 35 head trauma.History : sudden days-weeksoccasionally months -years episodes.,BPPV ,Nystagmus : characterization and types RT / LT , vertical / horizontal , changingTortional = Rotational clockwise / counterclockwiseGeotropic- toward the earthAgeotropic opposite,Physical : neurological examination normal except Dix-Hallpike pathognomonic,Fig.6 仰卧位转头试验,BPPV的临床类型,后半规管BPPV （PC-BPPV）水平半规管BPPV （HC-BPPV）上半规管性BPPV （SC-BPPV）混合型BPPV(C-BPPV),BPPV - Causes,Predisposing factors :Inactivity Acute alcoholismMajor surgeryCNS disease,Causes ( cont. ),Idiopathic 39% Ear disease 29%OM 9%Vestibular neuritis 7%Meniers dis 7%Otosclerosis 4%Sudden SNHL 2%Trauma 21%,BPPV - D.D,Meniers diseaseInner ear concussionAlcohol intoxicationLabyrinthitisVascular loop syndromePost. Fossa lesions : acustic neuroma , meningiomaCentral origion : stroke , MS , cerebellar degenerationVertibral artery insuffeciency,BPPV - Treatment,Watchful waitingVestibular suppressant medicationsVestibular rehabilitationCanalith repositioningSurgery careLabyrinthectomyPost. Canal occlusionSingula neurectomy Transtympanic aminpglycoside application,CRP Epley maneuver,CRP Semont maneuver,Brandt-Daroff Exsercise,Vestibu