不同眼动特征在中枢性孤立性眩晕中的诊断价值

doi:10.3969/j.issn.1673-5765.2021.04.016

摘要/Abstract

摘要：

目前研究认为，孤立性眩晕是后循环TIA或脑梗死的常见表现形式，而且当中枢病变患者以前庭症状发病时，初始的临床表现中，孤立性眩晕较非孤立性眩晕更为常见。长期以来，临床医师对中枢性眩晕的诊断多基于临床体征的定位诊断，事实上，在脑干和小脑中包含诸多调控眼动的中枢前庭结构，这些结构受损会导致相应的异常眼动模式。本文综述了中枢性孤立性眩晕的临床表现及不同眼动特征，并对其中包含的6个中枢前庭结构（前庭神经核、舌下前核、小脑下脚、小结叶、小脑扁桃体、绒球叶）的病变特点进行了系统介绍，旨在促进临床医师对中枢性孤立性眩晕的认识，提高鉴别诊断的水平。

文章导读： 脑干和小脑特定部位梗死会出现中枢性孤立性眩晕，临床上与外周性眩晕不易区别，但不同部位的梗死往往表现出不同的眼震特点，而且可以通过细致的临床查体发现，是临床上判断中枢性病变的重要依据。

关键词: 孤立性眩晕; 后循环缺血; 血管源性眩晕

Abstract:

Isolated vertigo is a common presentation in posterior circulation TIA and stroke. Of the vestibular symptoms of initial presentation, isolated vertigo is much more often than nonisolated vertigo. For a long time, the diagnosis of central vertigo was made mostly based on routine clinical positioning. In fact, the brain stem and cerebellum contain many central vestibular structures that regulate eye movement, and the damage of which can lead to eye movement impairment. This article reviewed the clinical manifestation and different eye movement characteristics of central isolated vertigo, and 6 central vestibular structures (vestibular nuclei, nucleus pre-positus hypoglossi, inferior cerebellar peduncle, nodulus, tonsillar and floccular), aiming at promoting clinical understanding and differential diagnosis for central isolated vertigo.

Key words: Isolated vertigo; Posterior circulation ischemia; Vascular-origin vertigo

平曼，米东华，李子孝，赵性泉，王拥军. 不同眼动特征在中枢性孤立性眩晕中的诊断价值[J]. 中国卒中杂志, 2021, 16(04): 413-418.

PING Man, MI Dong-Hua,LI Zi-Xiao, ZHAO Xing-Quan, WANG Yong-Jun. Diagnostic Value of Different Eye Movement Characteristics in Central Isolated Vertigo[J]. Chinese Journal of Stroke, 2021, 16(04): 413-418.

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