positional vertigo

Introduction

Introduction to positional vertigo Positional vertigo (positionalvertigo), also known as ampullary apex otolith, is more common in adults aged 40 to 60 years, more common in women. It can be a trigger for the sensitivity of gravity stimulation, which is induced by a certain head position and lasts for less than 30 seconds. The general incubation period is 2 to 3 seconds, and the duration is rarely more than 1 minute. There is very little nausea, vomiting, cold sweating, and less dumping. There are no tinnitus and deafness in the onset of vertigo, and the existing cochlear symptoms are not aggravated. The condition is relieved within weeks or months, and individuals can stay for several years. basic knowledge The proportion of the disease: the middle-aged and elderly people over 50 years old are more common, the incidence rate is about 5% Susceptible people: more common in adults aged 40 to 60 Mode of infection: non-infectious Complications: dizziness, nausea and vomiting

Cause

Cause of location vertigo

Organic lesions (35%)

Due to the spontaneous degeneration of the elliptical sac, the otolith is detached from the cystic plaque and deposited on the posterior ampulla. Gammaglobulinemia, globulin deposition on the ampulla of the ampulla, or the alcohol of the alcoholic drinker makes the ampulla of the ampulla thinner, can produce intrinsic, when the child with severe deafness wears high-intensity (120-130dB) hearing aid, about half Positional vertigo occurs.

Virus infection (25%):

Infection can induce this disease, for example, in the process of viral labyrinthitis or chronic suppurative otitis media, white blood cells, phagocytic cells or endothelial fibrin enter the lymphatic fluid; brain trauma or sacral surgery, blood into the lymphatic fluid, can be Formed tangible particles, deposited in the ampulla of the ampulla, Barber reported that the humeral longitudinal fracture, 47% of patients may have positional vertigo, 20% of those without fractures, Dix and Hallpike (1952) report 100 In patients with otitis media, 26% had location vertigo, ear surgery such as tympanoplasty, mastoidectomy and other vestibular lesions, but also the disease.

Other factors (15%):

Lindsay, Cawthorne found that the anterior vestibular artery and the superior vestibular nerve branch of the elliptical sac and the upper semicircular canal and the external semicircular canal degeneration, while the balloon and the posterior semicircular canal are normal, it is considered that hypertension, heart disease and vertebral artery insufficiency, Causes anterior vestibular artery embolism, which causes the otolith membrane to degenerate, fall off, and deposit on the ampulla.

Prevention

Positional vertigo prevention

The etiology of this disease is complex and not fully understood. Without special precautions, the disease can resolve within weeks to months, but may recur after months or years.

In the diet, it is advisable to eat light and damp products such as melon, corn, millet, lotus leaf porridge, radish, beans and soy products, black fungus, eggplant, pea sprouts, tomatoes, lettuce, orange, grapefruit, peach, Soybean oil, tea, squid, sea bream, etc. Among them, special emphasis is placed on eating more kumquats, oranges and radishes. Kumquat can regulate qi, relieve phlegm and phlegm.

Complication

Positional vertigo complications Complications, dizziness, nausea and vomiting

Dizziness, nausea, vomiting, etc. occur in a certain position or position.

Symptom

Symptoms of positional vertigo Common symptoms Nausea, vertigo, vertigo, vertigo, dizziness, severe dizziness, unstable standing, cold sweat

1. The whole body is in good condition. Dizziness, nausea, vomiting, etc. occur only in a certain position or head position. If you change your position to the other side, you will get better quickly. After repeating a certain position, the symptoms will appear again. The general incubation period is 2 to 3 seconds. The duration is rarely more than 1 minute, and there is very little nausea, vomiting, cold sweating, and less dumping.

2, there is no tinnitus in the vertigo episode, deafness, the existing cochlear symptoms are not aggravated.

3, the condition is more than a few weeks or months to relieve, individual can also wait for several years.

4, no headache during the disease, and no other central nervous signs.

Examine

Positional vertigo check

1. Head position nystagmus examination allows the patient to sit on the bed, first lying down on the head, observe 10 seconds without dizziness and nystagmus, then sit up and observe for another 10 seconds, then let the head side to the side and observe for 10 seconds, then Sit back to the other side, observe for 10 seconds, each time you change your position, sit up and lie down should be completed within 3 seconds. If nystagmus occurs in a certain position, you should continue to observe for 30 seconds. If it disappears, it is positive for the test. If the right ear is down, the nystagmus is turned to the right, and when the eye is gazing to the left, vertical nystagmus occurs. The repeated tests are positive, which is called non-fatigue type. Conversely, repeated tests no longer appear. Earthquake, called fatigue type, the direction of the nystagmus appearing in different head positions is called directional type; if nystagmus in different directions is called directional, the nystagmus appears in the unidirectional head position, and the duration is longer. Short, there is incubation period, oriented fatigue responders, mostly peripheral lesions; otherwise, most of them are central lesions, and other tests such as visual tracking and visual motion are generally normal.

2. The vestibular function test such as hot and cold temperature change is normal.

3, pure tone hearing test is more normal.

Diagnosis

Diagnosis of location vertigo

Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.

Differential diagnosis

(1) Central position vertigo is common in the fourth ventricle tumor and vascular lesions of the brain. It may have headache, nausea, vomiting and other positive neurological signs. It often has spontaneous nystagmus. The positional astigmatism lasts for more than 30 seconds, no incubation period. No fatigue, CT and MRI can be further diagnosed.

(B) sudden onset of vestibular neuritis, which lasts for several days, the cold and heat test is reduced, there is a history of upper respiratory tract infection, and the white blood cells of the blood are slightly increased.

(C) Cervical spondylosis cervical vertebra hyperplasia, can compress the vertebral artery or stimulate the cervical sympathetic nerve and cause vertebral artery spasm, so that the vestibular blood supply is insufficient, more common in adults over 40 years old, vertigo episodes are related to the specific head and neck position, often combined with other vertebral bases Symptoms of arterial insufficiency, such as headache, visual impairment and upper limb numbness, cervical X-ray film can be seen in the 4th to 6th cervical vertebrae with bone hyperplasia or other malformations.

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