第35讲 眩晕：病因、病理生理学和治疗Vertigo: Causes, P...

第35讲 眩晕：病因、病理生理学和治疗

Vertigo: Causes, Pathophysiology and Treatments

所属课程

神经病和精神病学理论与实践

课程视频： 43 个

《神经病和精神病学理论与实践》暂定42 + 1节课，包含脑卒中、癫痫、阿尔茨海默病、动脉畸形、脑动脉瘤等神经系统病变精美视频，适合医学/护理学生和患者教育。

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

眩晕是您或您的周围环境在移动或旋转的感觉。

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

这不是一种疾病，而是损害身体平衡系统——前庭系统的许多疾病的症状。

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

前庭系统由位于内耳周围感觉器官和大脑的中央处理中心组成。

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

3 个半规管可感知头部旋转，2 个耳石器官可感知头部位置和直线运动。

The canals contain a fluid called endolymph.

管道含有一种称为内淋巴的液体。

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

当头部转动时，液体会移动，这种运动会激活感觉神经元，将信息发送到大脑。

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

耳石器官含有碳酸钙晶体，有助于检测头部相对于重力的方向。

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

前庭信息通过前庭耳蜗神经传输到大脑的各个中心，进行解释和反应。

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

眩晕可能是由影响感觉器官、神经或大脑的多种疾病引起的。

Most common causes include:

最常见的原因包括

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

良性阵发性位置性眩晕; 内耳或前庭神经感染或炎症，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.

耳石器官的晶体从正常位置脱落，并被困在一个半规管内时，发生良性阵发性位置性眩晕 (BPPV)。

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

这可能是由于耳受伤、感染或衰老

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

晶体会破坏液体的正常运动，向大脑发送错误的、令人困惑的信号。

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

症状反复，持续约 1 分钟。

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

症状通常由躺下、坐下或站立、走路或在床上翻身等动作触发。

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

除头晕和旋转感外，患者也可能出现恶心、呕吐和异常节律的眼球运动。

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通常在几周后自行消退，但症状可能非常可怕，失去平衡可能会增加跌倒和事故的风险。

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

另外，这种情况可以通过一种称为耳石粒子复位术的简单疗法进行有效治疗。

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.

该过程包括头部位置的一系列变化，旨在将晶体移出半规管，并恢复到正常位置。

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.

内耳的病毒感染会导致前庭迷路炎症 - 迷路炎，或前庭神经炎症 - 前庭神经炎，这两种疾病都会导致眩晕。

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

迷路还包括负责听力的耳蜗，因此迷路炎也会导致听力问题。

Other signs may include nausea and vision changes.

其他体征可能包括恶心和视力变化。

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

对于这两种情况，症状会突然出现，并且可能很严重，但通常会在几周内逐渐改善。

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

一些患者完全康复，而另一些患者可能有迁延的症状，需要进行前庭康复锻炼以恢复前庭功能。

Ménière’s disease is another common cause of vertigo.

梅尼埃病是眩晕的另一个常见原因。

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

这种疾病的特点是内耳的流体压力异常高，影响平衡和听力。

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

症状包括耳压或耳涨满感、耳鸣、听力波动以及可持续数分钟至数小时的眩晕发作。

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，也无法治愈，但病情通常会随着时间的推移而改善，治疗有助于缓解症状。