常见的位置性眩晕分为良性阵发性位置性眩晕和中枢性位置性眩晕。在中枢性位置性眩晕患者患病早期,MRI检查对小病灶显影不理想,视动检查、头脉冲-眼震-扭转偏斜检查法非鉴别良性阵发性位置性眩晕和中枢性位置性眩晕的金标准。该文报道1例良性阵发性位置性眩晕的64岁女性患者,其因突发性眩晕伴恶心、呕吐就诊,考虑其有高血压病及脑梗死病史,MRI检查、视动检查、头脉冲试验结果不排除中枢性位置性眩晕的可能。但患者共济运动、神经系统检查正常,变位试验阳性,头转向右侧时眩晕明显,遂试行右侧耳石复位治疗,经治疗后患者眩晕及头昏逐渐改善,最后确诊为良性阵发性位置性眩晕,出院后1个月无复发。该例提示,详细的问诊、认真的体格检查及完善相关辅助检查对降低良性阵发性位置性眩晕误诊率十分重要。

Positional vertigo can be divided into benign paroxysmal positional vertigo and central positional vertigo. In the early stage of patients with central positional vertigo, the imaging of smaller lesions on MRI is not obvious,optokinetic examination and head impu-nystagmus-test of skew are not the gold standards for identifying benign paroxysmal positional vertigo and central positional vertigo. In this paper, one case of 64-year-old female with benign paroxysmal positional vertigo was reported. She was admitted to hospital due to sudden vertigo with nausea and vomiting. History of hypertension and cerebral infarction, results of MRI, optokinetic examination and head impulse examination indicated that the patient might suffer from central positional vertigo. However, normal results of coordination movement and neurological examination, positive result of Dix-Hallpike and roll test couldn’t rule out the possibility of benign paroxysmal positional vertigo. Since vertigo was evident when the patient’s head turned to the right, Epley respositioning procedure was done on her right ear. After therapy, the patient’s symptoms improved, and her benign paroxysmal positional vertigo was diagnosed finally. No recurrence was found after one month follow-up. In order to reduce the occurrence of misdiagnosis, detailed inquiry of medical history, careful physical and assistant examinationand must be implemented in patients with vertigo.

The authors have declared that no competing interests exist.

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