第35講 眩暈：病因、病理生理學(xué)和治療

Vertigo: Causes, Pathophysiology and Treatments

所屬課程

神經(jīng)病和精神病學(xué)理論與實(shí)踐

課程視頻： 43 個(gè)

《神經(jīng)病和精神病學(xué)理論與實(shí)踐》暫定42 + 1節(jié)課，包含腦卒中、癲癇、阿爾茨海默病、動(dòng)脈畸形、腦動(dòng)脈瘤等神經(jīng)系統(tǒng)病變精美視頻，適合醫(yī)學(xué)/護(hù)理學(xué)生和患者教育。

Vertigo is a sensation that you or your surroundings are moving or spinning.

眩暈是您或您的周圍環(huán)境在移動(dòng)或旋轉(zhuǎn)的感覺。

It’s not a disease but a symptom of any of the many conditions that impair the body’s balance system – the vestibular system.

這不是一種疾病，而是損害身體平衡系統(tǒng)——前庭系統(tǒng)的許多疾病的癥狀。

The vestibular system consists of peripheral sensory organs located in the inner ear, and central processing centers in the brain.

前庭系統(tǒng)由位于內(nèi)耳周圍感覺器官和大腦的中央處理中心組成。

There are 3 semicircular canals that sense head rotations, and 2 otolithic organs that sense head positions and linear motions.

3 個(gè)半規(guī)管可感知頭部旋轉(zhuǎn)，2 個(gè)耳石器官可感知頭部位置和直線運(yùn)動(dòng)。

The canals contain a fluid called endolymph.

管道含有一種稱為內(nèi)淋巴的液體。

When the head turns, the fluid moves and this movement activates sensory neurons to send information to the brain.

當(dāng)頭部轉(zhuǎn)動(dòng)時(shí)，液體會(huì)移動(dòng)，這種運(yùn)動(dòng)會(huì)激活感覺神經(jīng)元，將信息發(fā)送到大腦。

The otolithic organs contain calcium carbonate crystals which help detect head orientation in relation to gravity.

耳石器官含有碳酸鈣晶體，有助于檢測(cè)頭部相對(duì)于重力的方向。

Vestibular information is transmitted via the vestibulocochlear nerve to various centers in the brain, where it is interpreted and reacted upon.

前庭信息通過前庭耳蝸神經(jīng)傳輸?shù)酱竽X的各個(gè)中心，進(jìn)行解釋和反應(yīng)。

Vertigo can be caused by a number of conditions that affect the sensory organs, the nerve, or the brain.

眩暈可能是由影響感覺器官、神經(jīng)或大腦的多種疾病引起的。

Most common causes include:

最常見的原因包括

benign paroxysmal positional vertigo; infection or inflammation of the inner ear or vestibular nerve, and Ménière’s disease.

良性陣發(fā)性位置性眩暈; 內(nèi)耳或前庭神經(jīng)感染或炎癥，以及 Ménière 病。

Benign paroxysmal positional vertigo, BPPV, occurs when the crystals in an otolithic organ become dislodged from their normal location, and get trapped inside one of the semicircular canals.

耳石器官的晶體從正常位置脫落，并被困在一個(gè)半規(guī)管內(nèi)時(shí)，發(fā)生良性陣發(fā)性位置性眩暈 (BPPV)。

This can happen because of an injury to the ear, infection or old age.

這可能是由于耳受傷、感染或衰老

The crystals disrupt the normal movement of the fluid, sending erroneous, confusing signals to the brain.

晶體會(huì)破壞液體的正常運(yùn)動(dòng)，向大腦發(fā)送錯(cuò)誤的、令人困惑的信號(hào)。

Symptoms come and go as episodes that last about a minute.

癥狀反復(fù)，持續(xù)約 1 分鐘。

The episodes are typically triggered by movements such as lying down, sitting or standing up, walking, or turning over in bed.

癥狀通常由躺下、坐下或站立、走路或在床上翻身等動(dòng)作觸發(fā)。

Apart from dizziness and sensation of spinning, patients may also experience nausea, vomiting and abnormal rhythmic eye movements.

除頭暈和旋轉(zhuǎn)感外，患者也可能出現(xiàn)惡心、嘔吐和異常節(jié)律的眼球運(yùn)動(dòng)。

BPPV usually resolves on its own after a few weeks, but symptoms can be very frightening and loss of balance may increase risk of falls and accidents.

BPPV通常在幾周后自行消退，但癥狀可能非?？膳?，失去平衡可能會(huì)增加跌倒和事故的風(fēng)險(xiǎn)。

Alternatively, the condition can be treated effectively with a simple therapy known as particle repositioning procedure.

另外，這種情況可以通過一種稱為耳石粒子復(fù)位術(shù)的簡(jiǎn)單療法進(jìn)行有效治療。

The procedure involves a series of changes in the head’s position, designed to move the crystals out of semicircular canals and back into their normal location.

該過程包括頭部位置的一系列變化，旨在將晶體移出半規(guī)管，并恢復(fù)到正常位置。

A viral infection of the inner ear can cause inflammation of the vestibular labyrinth - labyrinthitis, or inflammation of the vestibular nerve - vestibular neuritis, both of which can lead to vertigo.

內(nèi)耳的病毒感染會(huì)導(dǎo)致前庭迷路炎癥 - 迷路炎，或前庭神經(jīng)炎癥 - 前庭神經(jīng)炎，這兩種疾病都會(huì)導(dǎo)致眩暈。

The labyrinth also includes the cochlea that is responsible for hearing, so labyrinthitis also results in hearing problems.

迷路還包括負(fù)責(zé)聽力的耳蝸，因此迷路炎也會(huì)導(dǎo)致聽力問題。

Other signs may include nausea and vision changes.

其他體征可能包括惡心和視力變化。

For both conditions, symptoms appear suddenly and can be severe, but typically improve gradually over several weeks.

對(duì)于這兩種情況，癥狀會(huì)突然出現(xiàn)，并且可能很嚴(yán)重，但通常會(huì)在幾周內(nèi)逐漸改善。

Some patients recover completely while others may have lingering symptoms and require vestibular rehabilitation exercises to restore vestibular functions.

一些患者完全康復(fù)，而另一些患者可能有遷延的癥狀，需要進(jìn)行前庭康復(fù)鍛煉以恢復(fù)前庭功能。

Ménière’s disease is another common cause of vertigo.

梅尼埃病是眩暈的另一個(gè)常見原因。

The disease is characterized by an abnormally high fluid pressure in the inner ear that affects both balance and hearing.

這種疾病的特點(diǎn)是內(nèi)耳的流體壓力異常高，影響平衡和聽力。

Symptoms include a feeling of ear pressure or fullness, ear ringing, fluctuating hearing, and episodes of vertigo that can last from minutes to hours.

癥狀包括耳壓或耳漲滿感、耳鳴、聽力波動(dòng)以及可持續(xù)數(shù)分鐘至數(shù)小時(shí)的眩暈發(fā)作。

The cause is unknown and there is no cure, but the condition usually improves over time, and treatments can help to relieve symptoms.

原因不明，也無法治愈，但病情通常會(huì)隨著時(shí)間的推移而改善，治療有助于緩解癥狀。