Epidemiology Of Vertigo And The Accurate Diagnosis And Treatment Of Vestibular Neurons

This study includes two parts,one is the epidemiological study of vertigo,and the other is the accurate diagnosis and treatment of vestibular neuron.Part 1.Epidemiological study of vertigoAim: To summarize the etiology of vertigo patients,and to provide evidence for the accurate diagnosis and treatment of vertigo or dizziness.Method: Summary 6450 vertigo cases from vertigo center clinic of Air Force General Hospital of PLA during Jan to Dec 2016,and picked out 1419 patients diagnosed by a team of experts,who had general practitioners working experience,for etiology stratified analysis by gender and age.Result:(1)Top 9 etiological factor of the vertigo/dizziness patients as benign paroxysmal positional vertigo(BPPV)38.55%(547/1419),vestibular migraine(VM)21.92%(311/1419),vestibular neuritis(VN)7.89%(112/1419),Meniere disease(MD)6.20%(88/1419),the psychic vertigo(PV)4.65%(66/1419),Hypertension 3.24%(46/1419),cerebral infarction(PCI)2.54%(36/1419),sudden deafness with vertigo(SD)1.48%(21/1419),and coronary heart disease(CHD)0.85%(12/ 1419).Vestibular peripheral vertigo accounted for 56.03%(795/1419),central vertigo accounted for 24.59%(349/1419),vertigo/dizziness caused by systemic disease accounted for 10.50%(149/1419),and unexplained vertigo/dizziness accounted for 8.88%(126/1419).(2)The age of patients between 9-90 years old,and the top 4 etiological factor stratified by age were: <18 group BPPV(6 cases),motion sickness(6 cases),VM(5 cases),VN(3 cases),26 cases in total;18-44 years old group BPPV(161 cases),VM(103 cases),VN(35 cases),MD(17 cases),a total of 412 cases;45-59 years old group BPPV(213 cases),VM(117 cases),MD(48 cases),VN(38 cases),548 cases in total;60-74 years old group BPPV(147 cases),VM(68 cases),Hypertension(30 cases),VN(30 cases),a total of 343 cases;and 75-90 years old group PCI(36 cases),BPPV(20 cases),VM(18 cases),VN(6 cases),a total of 90 cases.(3)Male: Female = 1:1.79 among 1419 patients.PV and unexplained vertigo/dizziness are more common in female(?2=4.02,29.94,P<0.05,P<0.01),while Hypertension and PCI are more common in male(?2=17.90,21.32 P<0.01)stratified by gender,and the difference was statistically significant.Conclusion: Vertigo/dizziness represent complex,involves many traditional disciplines,and so difficult to diagnose.Etiology,age and gender stratification rules in vertigo center clinic will help to improve the precision level of vertigo/dizziness diagnosis and treatment.Part 2.The accurate diagnosis and treatment of vestibular neuronAim: Analysis of vestibular neuronitis prospective treatment and follow-up data,to provide the basis for accurate diagnosis and treatment of peripheral vestibular vertigo.Method: 50 patients with vestibular neuritis(VN),diagnosed in vertigo center clinic of Air Force General Hospital of PLA during May 2015 to Nov 2016,were randomly divided into study group(n = 26)and control group(n =24).The study group was given methylprednisolone treatment and peripheral vestibular rehabilitation therapy,and the control group was given methylprednisolone alone.Spontaneous nystagmus(SN),caloric test(CT),vestibular muscle evoked potential(VEMP),vestibular autorotation test(VAT)and subjective visual vertical(SVV)were comparative for study group and control group at admission,1 month after treatment,and 3 months after treatment.Result:(1)After 1 month,the directional preponderance of CT(DP)decreased(t=3.428,P < 0.05)of the study group(21.09±16.90)% comparative with the control group(41.11±24.03)%,VEMP extraction rate increased(P < 0.05)of the study group(17/23)comparative with the control group(18/18),dynamic balance score increased(t=2.682,P < 0.05)of the study group(70.77±16.15)comparative with the control group(53.83±26.76).(2)After 3 months,canal paresis(CP)decreased(t=2.583,P < 0.05)of the study group(33.26±20.01)% comparative with the control group(50.07±25.42)%,DP decreased(t=4.412,P < 0.05)of the study group(8.63 ±5.65)%comparative with the control group(17.98 ± 8.84)%,and the comprehensive dynamic balance score increased(t=3.173,P < 0.05)of the study group(81.58±3.67)comparative with the control group(62.50±29.24).Conclusion: Peripheral vestibular rehabilitation can accelerate vestibular compensation and is an effective treatment for vestibular neurons.