Đặc điểm lâm sàng và kết quả đo ảnh động nhãn đồ (VNG) của người bệnh chóng mặt tư thế kịch phát lành tính tại Bệnh viện Đa khoa Tâm Anh năm 2022 – 2023=Clinical features and videonystagmography (VNG) results of patients with benign paroxysmal positional vertigo at Tam Anh General Hospital from 2022 to 2023

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thị Kiều Trang Đỗ, Quốc Khánh Đoàn, Minh Kỳ Lê, Thị Hà Nguyễn, Thị Nhan Nguyễn, Văn Liệu Nguyễn, Hồng Tĩnh Phạm, Thị Như Quỳnh Phạm, Việt Tuấn Phạm

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.279-286

Bộ sưu tập: Báo, Tạp chí

ID: 243844

Thêm vào giỏ

Benign paroxysmal positional vertigo (BPPV) reigns as the most prevalent peripheral vestibulopathy, characterized by episodic vertigo and nystagmus elicited by specific head repositioning maneuvers like the Dix-Hallpike maneuver and Head-Roll test. Recent advancements in Vietnamese healthcare have seen the introduction of state-of-the-art techniques like videonystagmography (VNG). This technology empowers clinicians with a noninvasive and objective method for localizing canalith canal involvement, ultimately refining the selection of appropriate canalith repositioning maneuvers for optimal treatment outcomes. Subjective: Patients were diagnosed with BPPV at Tam Anh General Hospital from 2022 to 2023. Method: A descriptive study. Results: A preponderance of patients identified as female, constituting approximately 75% of the study group. The age bracket of 61- 70 years exhibited the highest prevalence, encompassing roughly 24% of the study population. The most frequently reported symptom was a spinning sensation, affecting 92.5% of patients. Nausea emerged as the most prevalent co-occurring symptom, with a prevalence of 85.5%. A significant portion of patients also reported oscillopsia and vomiting. 25% of the study population presented with bilateral BPPV. Posterior canal otolithiasis emerged as the most common subtype of BPPV. Conclusion: 92.5% of patients diagnosed with CMTTKPLT have severe, sudden, spinning vertigo attacks of extremely short duration (seconds to minutes), attacks appear when changing head position. Results of measuring VNG in patients with BBPV showed that most of the tympanic stones were ectopic in the posterior semicircular canal. VNG serves as a pivotal diagnostic tool, empowering clinicians to achieve precise localization of canalith canal involvement. This enhanced the selection of the most appropriate canalith repositioning maneuvers, ultimately optimizing treatment efficacy.Chóng mặt tư thế kịch phát lành tính (CMTTKPLT) là một trong những nguyên nhân phổ biến gây chóng mặt ngoại biên và thường gặp ở lứa tuổi từ 50 - 70 tuổi. CMTTKPLT được đặc trưng bởi chóng mặt và rung giật nhãn cầu khi người bệnh được làm nghiệm pháp Dix – Hallpike hoặc Head-Roll tuỳ thuộc vào vị trí của thạch nhĩ lạc chỗ. Thời gian, tần suất và cường độ các triệu chứng thay đổi tùy thuộc vào ống bán khuyên (ÔBK) và vị trí của thạch nhĩ. Hiện nay có nhiều hệ thống khám tiền đình hiện đại dùng để chẩn đoán chính xác nguyên nhân gây nên hội chứng tiền đình, trong đó hệ thống ảnh động nhãn đồ (VNG) được dùng để ghi lại và lượng giá hệ thống vận động nhãn cầu và phản xạ tiền đình mắt. VNG kết hợp với lâm sàng có thể phát hiện được thạch nhĩ lạc chỗ lạc vào ÔBK nào, một bên hay hai bên để từ đó đưa ra liệu trình thích hợp để tái định vị thạch nhĩ. Đối tượng và phương pháp nghiên cứu: Người bệnh được chẩn đoán chóng mặt tư thế kịch phát lành tính tại khoa Thần Kinh và khoa Tai Mũi Họng – Bệnh viện Đa khoa Tâm Anh. Nghiên cứu tiến cứu mô tả cắt ngang. Kết quả: Trong số 200 người bệnh được nghiên cứu có 149 người bệnh là nữ giới, chiếm 75%. Nhóm tuổi 61-70 có nhiều người bệnh nhất (48 người bệnh, chiếm 24%). Phần lớn người bệnh có cảm giác chóng mặt quay (185 người bệnh, chiếm 92,5%). Buồn nôn là biểu hiện kèm theo thường gặp nhất với 171 người bệnh có biểu hiện này, chiếm 85,5%. 50 người bệnh, chiếm 25%, có thạch nhĩ lạc chỗ vào ÔBK cả hai bên. Số lượng thạch nhĩ lạc chỗ ÔBK sau chiếm ưu thế với 198/288 ÔBK có thạch nhĩ lạc chỗ. Kết luận: 92,5% người bệnh được chẩn đoán CMTTKPLT có các cơn chóng mặt quay dữ dội, đột ngột, trong thời gian cực ngắn (mấy giây đến vài phút), cơn xuất hiện khi thay đổi tư thế đầu. Kết quả đo VNG ở người bệnh CMTTKPLT cho thấy đa phần thạch nhĩ lạc chỗ ở ống bán khuyên sau. Sử dụng VNG giúp xác định vị trí thạch nhĩ lạc chỗ, qua đó giúp thực hiện các nghiệm pháp tái định vị thạch nhĩ hiệu quả.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR