91例儿童眩晕症的诊疗分析

Analysis of diagnosis and treatments for 91 cases with vertigo in children

摘要:

目的 探讨儿童眩晕症的组成和临床治疗效果。方法 回顾性分析2020年1月—2023年6月苏州大学附属儿童医院收治的91例儿童眩晕症患者临床资料，对儿童眩晕症的构成、临床特点进行分析以及根据其病因进行治疗并密切随访。结果 儿童复发性眩晕37例(40.7%)，前庭性偏头痛17例(18.7%)，良性阵发性位置性眩晕8例(8.8%)，梅尼埃病6例(6.6%)，儿童前庭性偏头痛可疑5例(5.5%)，前庭神经炎5例(5.5%)，精神性眩晕5例(5.5%)，中耳胆脂瘤致半规管瘘3例(3.3%)，突发性聋伴眩晕2例(2.2%)，小脑共济失调1例(1.1%)，蛛网膜巨大囊肿1例(1.1%)，先天性眼震1例(1.1%)。根据不同病因综合治疗后，73例患儿眩晕症状得到不同程度的缓解。结论 研究发现儿童眩晕症中最常见的是复发性眩晕，其次是前庭性偏头痛及良性阵发性位置性眩晕。需要根据患儿的病史、体格检查、影像学检查及前庭功能检查结果进行综合分析，其治疗需要针对不同类型的眩晕给予患儿个体化的综合治疗。

Abstract:

Objective To identify clinical characteristics of vertigo and explore clinical therapeutic effect of vertigo in children. Methods A retrospective analysis was conducted on the clinical data of 91 children with vertigo admitted to Children’s Hospital of Soochow University from January 2020 to June 2023. The composition and clinical characteristics of children vertigo were analyzed, and treatment and follow-up observations were carried out according to the etiologies. Results The diagnoses of 91 children with vertigo included recurrent vertigo (n=37, 40.7%) , vestibular migraine (n=17, 18.7%), benign paroxysmal positional vertigo(n=8, 8.8%), Meniere’s disease (n=6, 6.6%), probable vestibular migraine (n=5, 5.5%), vestibular neuritis (n=5, 5.5%), psychogenic vertigo(n=5, 5.5%)，semicircular canal fistula caused by middle ear cholesteatoma(n=3, 3.3%), sudden deafness with vertigo (n=2, 2.2%),cerebellar ataxia(n=1, 1.1%), giant arachnoid cyst(n=1, 1.1%), and congenital nystagmus(n=1, 1.1%). After comprehensive treatment based on different etiologies, the vertigo symptoms of 73 children were relieved to varying degrees. Conclusions This study found that the most common type of vertigo in children is recurrent vertigo, secondly vestibular migraine and benign paroxysmal positional vertigo. It is necessary to conduct a comprehensive analysis based on the child’s medical history, physical examination, imaging examination, and vestibular function test results. The treatment should be individualized and comprehensive according to different vertigo in children.