Comparative Analysis Of Typical BPPV And Atypical BPPV In Neurology Clinic

Objective:Collecting the data of patients with atypical benign paroxysmal positional vertigo(BPPV)in the outpatient department of Neurology,the relevant clinical features were analyzed to improve the understanding of atypical BPPV,study the therapeutic effect of atypical BPPV,and expand the diagnosis and treatment ideas.Materials and methods:From June to December 2018,641 patients diagnosed with BPPV in the neurology outpatient department of Bethune first hospital of JiLin university due to vertigo were collected,including typical patients and atypical patients.General information such as gender,age,duration of vertigo symptoms,medication status and other symptom-related information were investigated.Result:1.A total of 585 patients with typical BPPV and 56 patients withatypical BPPV were enrolled,accounting for 8.7%.2.Among the patients with atypical BPPV,there were 22 males and 34 females.3.Among the patients with atypical BPPV,the minimum age was 17,the maximum age was 75,and the average age was 51.5.The age of enrolled atypical BBPV patients was mainly between 50 and 59 years old.There was no statistical significance among different age groups(p > 0.05).4.No statistical significance was found between the history of hypertension and atypical BBPV(p>0.05).5.In the typical BPPV group,the duration of vertigo attack was less than 1 minute in 494 cases;There were 91 patients with 1 to 10 minutes.In the atypical BPPV group,the duration of vertigo attack was less than 1 minute in 43 patients and 1-10 minutes in 13 patients.There was no significant difference between the duration of vertigo symptoms and the diagnosis of atypical BPPV(p > 0.05).6.Among the enrolled patients in this study,a total of 76 patients were treated with drugs,and 565 patients were not treated with drugs.In the typical BPPV group,52 patients were treated with drugs,and 533 patients were not treated with drugs.In the atypical BPPV group,24 patients were treated with drugs,and 32 patients were not treated with drugs.Statistical analysis showed that drug therapy had statistical significance in the diagnosis of atypical BPPV(p<0.05).7.Among the56 patients with atypical BPPV,there were 20 patients with typical clinical symptoms without nystagmus,8 patients with atypical clinicalsymptoms with characteristic positional nystagmus,28 patients with typical clinical symptoms with characteristic positional nystagmus,and8 of them were considered to be diagnosed as horizontal canal canalolithiasis;One patient was considered to have multiple otolithiasis.In 13 patients presented with clinical symptoms and possible semicircular canal and the actual situation of inconsistency between semicircular canal of the disease,research has shown that there were 8patients according to their clinical thinking of diagnosis of posterior semicircular canal otolith starting position,but the actual risk for horizontal semicircular canal,five patients according to their symptoms start considering lesion site was located in the horizontal semicircular canal,but it was for the posterior semicircular canal.8.For patients with atypical BPPV,the efficacy of two reduction treatments was significantly higher than that of only one reduction treatment(P<0.05).Conclusion:1.Patients with atypical BPPV were mostly treated with typical positional vertigo symptoms,with or without positional nystagmus,and there was a mismatch between the semicircular canal judged by its clinical symptoms and signs and the actual diseased semicircular canal;Typical BPPV patients had typical positional vertigo and characteristic positional nystagmus.2.The use of intervention drugs was more likely tocause atypical BPPV,while the occurrence of typical BPPV was relatively rare.3.Compared with patients with typical BPPV,patients with atypical BPPV were recommended to require multiple reduction treatments.