关键词: 孤立性眩晕; 中枢性眩晕; 前庭周围性眩晕; 后循环缺血; 危险因素

Abstract:

Objective To analyze the causes of patients with isolated vertigo for early identification of isolated posterior circulation ischemia vertigo. Methods The clinical data of 171 patients with isolated vertigo were retrospectively analyzed. The different causes of vertigo were determined by associated medical history, clinical signs and symptoms, and the corresponding auxiliary examination results, such as imaging of the nervous system and cerebrovascular assessment. In order to evaluate anxiety or depression state, methods of Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) were adopted. Besides, Stroke Risk Score (SRS) was used to screen risk factors. Results In 171 cases, there were 19 patients (11%) caused by posterior circulation ischemia, 142 patients (83%) caused by peripheral vestibular vertigo, and 10 patients (6%) caused by anxiety or depression. There were no significant differences in clinical manifestations (position induced or aggregated vertigo, nausea and vomiting, nystagmus, tinnitus and hearing loss) among the three groups. There were statistically significant differences in the onset age (P =0.001), smoking proportion (P =0.004), incidence of diabetes mellitus (P =0.023), hypertension (P =0.015), coronary heart disease (P =0.021), high density lipoprotein cholesterol (P =0.002), history of transient ischemic attack/stroke (P =0.006) and the rate of SRS>7 (P <0.001) between the central vertigo and vestibular peripheral vertigo group. And the onset age (P =0.001), incidence of diabetes mellitus (P =0.011), hypertension (P =0.019), internal artery stenosis (P =0.027), and the rate of SRS>7 (P =0.003) were significantly higher in the central vertigo group compared with that of anxiety/depression group. Besides, the incidence of high density lipoprotein cholesterol was significantly higher in the peripheral group compared with that of anxiety/depression group (P =0.001). Conclusion Isolated vertigo are mainly non-central vascular vertigo, while acute cerebrovascular disease (mostly of posterior circulation ischemia) can be characterized by isolated vertigo. There are significant differences in the onset age, history of stroke risk factors between the central and non-central vertigo. In the clinical diagnosis and treatment we should focus on identifying central damage to avoid serious consequences.

Key words: Isolated vertigo; Central vascular vertigo; Vestibular peripheral vertigo; Posterior circulation ischemia; Risk factors