良性阵发性位置性眩晕
医学
眩晕
平衡问题
前庭系统
坠落(事故)
平衡(能力)
物理医学与康复
害怕跌倒
毒物控制
物理疗法
听力学
伤害预防
儿科
精神科
外科
医疗急救
作者
Yuxiao Li,Rebecca Smith,Susan L. Whitney,Barry M. Seemungal,Toby J. Ellmers
出处
期刊:Age and Ageing
[Oxford University Press]
日期:2023-11-02
卷期号:52 (11)
被引量:14
标识
DOI:10.1093/ageing/afad206
摘要
Abstract Benign paroxysmal positional vertigo (BPPV) is amongst the commonest causes of dizziness and falls in older adults. Diagnosing and treating BPPV can reduce falls, and thereby reduce fall-related morbidity and mortality. Recent World Falls Guidelines recommend formal assessment for BPPV in older adults at risk of falling, but only if they report vertigo. However, this recommendation ignores the data that (i) many older adults with BPPV experience dizziness as vague unsteadiness (rather than vertigo), and (ii) others may experience no symptoms of dizziness at all. BPPV without vertigo is due to an impaired vestibular perception of self-motion, termed ‘vestibular agnosia’. Vestibular agnosia is found in ageing, neurodegeneration and traumatic brain injury, and results in dramatically increased missed BPPV diagnoses. Patients with BPPV without vertigo are typically the most vulnerable for negative outcomes associated with this disorder. We thus recommend simplifying the World Falls Guidelines: all older adults (>60 years) with objective or subjective balance problems, irrespective of symptomatic complaint, should have positional testing to examine for BPPV.
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