儿童眩晕的诊断与治疗a.pptVIP

参考文献 * 幼儿常不能叙述清楚，不能分辨眩晕或头晕。同时也常因眩晕的恐惧经历导致卧床不敢恢复日常活动，误以为症状仍发生或持续 经常有人问我，非常希望能够看好眩晕疾病，但是不知道从何地方下手。我的回答是：首先一定要认识更多的眩晕疾病。这个道理很简单，如果你不认识BPPV，那么你即使遇到100个BPPV患者，你也不会诊断出来一个。 尽管到目前为止，相信仍然有眩晕疾病没有被人类所认识，但是尽可能的掌握现在认识到的眩晕疾病，遇到这些患者的时候，你才能说，我可以下一个明确的诊断。 * 对儿童眩晕疾病的最新的meta分析，综合了9项研究，共800多例进行meta分析 * * Diagnostic spectrum of the causes of dizziness in children. Data are pooled from Wiener-Vacher [7] (n2000), Lehnen et al. [6] (n400), and Gioacchiniet al. [4] (n724). Not all diagnoses were included in all studies. If a diagnosis was only recognized in one study and did not overlap with the remaining groups (e.g., vestibular paroxysmia first described in children by Lehnen et al. [6],4%), the group of unclear/other diagnoses (unlabeled, 11%)was reduced by an equivalent proportion to counter balance the bias. BPPV and orthostatic vertigo each account for 2% of the diagnoses. About 40% of patients are consistently diagnosed with migraine-related syndromes (vestibular migraine and BPV). BPPV, benign paroxysmal positioning vertigo; BPV, benign paroxysmal vertigo; CV, central vertigo (includes cerebellar syndromes, central ocular motor disorders, and episodic ataxia); HT, head trauma; OV, orthostatic vertigo; PVS, peripheral vestibular syndrome (includes unilateral and bilateral vestibular loss, vestibular neuritis, labyrinthitis, Menie`re’s disease, and vertigo in middle ear effusion/otitis media); SV, somatoform vertigo (includes phobic postural vertigo, chronic subjective dizziness, and vertigo in psychiatric disorders); VP,vestibular paroxysmia. BPPV，良性阵发性位置性眩晕; BPV，良性阵发性眩晕; CV，中枢性眩晕（包括小脑症状，中央眼球运动障碍和发作性共济失调）; HT，头部外伤; OV，体位性眩晕; PVS，周边前庭综合征（包括单侧和双侧前庭损失，前庭神经炎，迷路炎，Menie`re病，眩晕中耳积液/中耳炎）; SV，躯体形式眩晕（包括恐怖性体位性眩晕，慢性主观头晕，并在精神疾病眩晕）;VP，前庭paroxysmia International headache society classification subcommitee。 ICHD international classification of headache disorders * 2012年 This girl had her first attack when she was nineteen months old. The attacks recurred repeatedly every two to six months and la