| Objective:Through data collection of patients with atypical paroxysmal positional vertigo(BPPV)in the outpatient department of Neurology,the clinical features were analyzed to improve the understanding of atypical BPPV and reduce the rate of misdiagnosis.Materials and methods:From June 2017 to December,we collected 47 atypical BPPV patients diagnosed as atypical BPPV patients in the neurology department of the First Hospital of Jilin University,and collected sex,age,drug use,duration of vertigo attack,time of hospitalization,accompanying symptoms,history,family history,treatment effect,and so on.Result:1.Among the 568 patients diagnosed as BPPV,47 cases were atypical BPPV,accounting for 8.3%.2.Among the atypical BPPV patients,there were 12 male and 35 female patients,with a male to female ratio close to 1:3.3.From the perspective of age composition,the minimum age was 27,the maximum age was 78,and the average age was 55.2years.The proportion of patients aged 60~69 years is the largest.In atypical BPPV patients,there was no statistical significance in all age groups(p>0.05).4.We found that diabetes history,ear diseases and trauma history had statistical significance for atypical BPPV(p<0.05).Family history and history of hypertension were not statistically significant(p>0.05).5.In typical BPPV patients,480 patients continued for a few seconds to 1 minutes,and 41 patients in 1 minutes to 10 minutes.In atypical BPPV patients,39 patients lasted for a few seconds to 1 minutes,and 8 patients were 1 minutes to 10 minutes.The duration of vertigo was statistically significant in atypical BPPV(p<0.05).6.In the patients diagnosed with BPPV,292 patients were treated with anti vertigo drugs(including oral and intravenous infusion),and 276 patients were not treated with anti vertigo drugs.Among the typical BPPV patients,275 were given drug treatment,246 were not given drug treatment,17 were given medications in atypical BPPV patients and 30 patients were not given medication.The diagnostic value of anti vertigo drugs for atypical BPPV was statistically significant(p<0.05).7.Among 47 atypical BPPV patients,there were 17 cases of atypical BPPV with typical complaints and no nystagmus.There were 6 cases of atypical complaints and positional nystagmus.24 cases with typical complaints with positional nystagmus,4 of which considered Horizontal canal canalolithiasis;4 patients considered multiple canal otolithiasis;In other 16 cases,the main complaint was that the semicircular canals were not consistent with the actual semicircular canals,of which 11 cases were considered to be posterior semicircular otolith according to the first body position.The actual incidence was horizontal semicircular canals.5 patients considered the horizontal semicircular otolith according to the first body position,and the actual semicircular canals were located in the posterior semicircular canal.8.In 47 cases of atypical BPPV patients,33 patients were cured or improved after treatment,and the effective rate of reduction was 70.2%,which was lower than that of typical BPPV patients.The different types of atypical BPPV patients were statistically significant(p<0.05),of which the main complaint was not typical,and the position associated nystagmus treatment was the most effective,and the BPPV patients without positional nystagmus were the most invalid.9.There was no statistically significant difference in the time length of disease for atypical BPPV patients(p>0.05).Conclusion:1.Female patients with atypical BPPV are more than men,and the incidence of female patients in atypical BPPV is higher than that of typical BPPV patients.The age group has no effect on the incidence of the disease.2.The clinical manifestations of atypical BPPV are mainly transient related vertigo(some patients may only have dizziness),with or without nystagmus.Often accompanied by nausea and vomiting,sweating and other autonomic symptoms.3.The reduction effect of atypical BPPV patients is worse than that of typical BPPV patients.Multiple reduction can relieve symptoms. |
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