Treatment for Benign Paroxysmal Positional Vertigo with Canalith Repositioning Procedure

良性陣發姿勢性暈眩的治療方式：老年與非老年病患的比較

10.29462/TGG.200705.0003

程遠揚(Yuan-Yang Cheng)；陳至淳(Chih-Chun Chen)；陳亮恭(Liang-Kung Chen)；高崇蘭(Chung-Lan Kao)；詹瑞棋(Rai-Chi Chan)

良性陣發姿勢性暈眩BPPV ； 耳石復位術CRP ； benign paroxysmal positional vertigo ； canalith repositioning procedure

台灣老年醫學雜誌

2卷4期（2007 / 05 / 01）

251 - 262

英文

背景：良性陣發姿勢性暈眩(BPPV)是臨床上造成暈眩最常見的原因之一，而耳石復位術(CRP)則提供了一個安全、有效、經濟且又方便的治療方法。但臨床上由於良性陣發姿勢性暈眩常會隨時間自然痊癒，故耳石復位術的治療效果常受到質疑。 方法：在本文中，我們共收集了97位經過診斷及治療後的良性陣發姿勢性暈眩病患資料，並分析各半規管受到侵犯的盛行率、復發率、首次復發的時間，以及影響不同豐規管復發率及復發時間的因子。 結果：高達71.1%的病患僅經由一次的耳石復位術即完全治癒，復發率爲12.4%，而70歲以上的病患，其復發率爲其他族群的3倍之多。經耳石復位術後復發的時間爲8.4±5.2個月，而復發時間的長短與年齡及性別均無統計上的相關性。 結論：良性陣發姿勢性暈眩在老年人口中很常見，而耳石復位術仍是爲一項針對此類病患安全且有效的治療方式。因此臨床醫師應對此疾患有基本的認識，對暈眩的病患，尤其是老年人，進行正確的診斷與適當的治療以避免後續併發症的產生。

Background: Benign paroxysmal positional vertigo (BPPV) is one of the most common forms of vertigo, and the canalith repositioning procedure (CRP) provides a convenient, safe, economical and effective treatment for this specific type of disease. However, the therapeutic effects and recurrence rates of CRP among different age groups have not been examined before. Method: The study focuses on reporting the diagnoses and treatment results of 97 BPPV patients and analyzing the prevalence, recurrence rate, first recurrence duration, and risk factors of recurrence of different canal involvements. Result: Up to 71.1% of the patients were successfully treated by single CRP treatment. The overall recurrence rate read 12.4% while the group of patients aged more than 70 reported a recurrence rate more than 3 times higher than other age groups. The average time for recurrence was 8.4±5.2 months. No statistically significant difference was detected between duration of recurrence and gender or age. Conclusion: Benign proxysmal positional vertigo is prone to occur in elderly patients, and the canalith respositioning procedure provides an effective and safe treatment for BPPV patients. Clinicians should have the knowledge to diagnose different types of BPPV and treat them accordingly to prevent further complications, especially in the elderly population.