Source: Eye, Ear, Nose and Throat Hospital of Fudan University
Mrs. Zhang has been very distressed recently. She likes to sleep very much. As soon as she touches the pillow, she will immediately turn around and it will not last long. It only took ten seconds, but it was very uncomfortable, and I would feel nausea and even vomiting.
At first, Mrs. Zhang thought it was a cervical spondylosis, but she went to the orthopedic department and found no special problems. She also thought that it was because she was getting older and had a “cerebellar infarction”, so she went to the neurology department for an examination. It’s all good.
Mrs. Zhang was so anxious that she couldn’t sleep. At this time, a kind neighbor reminded her that she had suffered a similar problem before. The doctor of the ENT hospital said it was a disease called otolithiasis. Just turn him left and right on the bed. Mrs. Zhang seemed to have grabbed the last straw and immediately went to the ENT department of our hospital for an examination.
Doctor’s consultation
According to Mrs. Zhang’s condition description, ENT doctor Tang asked Here are a few questions for her:
How long has the vertigo been present? Is this the first time this has happened?
Does it happen every time in a certain position? Did you see the house moving when it happened? How long does the attack last?
Are you aware of each seizure? Have you experienced hearing loss since the onset?
Mrs. Zhang answered them one by one: “It’s been a week since dizziness happened, and it’s the first time this has happened. It’s especially easy to happen when you lie down in bed, especially when your head falls to the right side. , now I only dare to lie down slowly on the left side. The house turned around during the attack, which lasted about ten seconds. When the attack occurred, I was conscious and did not experience hearing loss.”
According to According to Mrs. Zhang’s answer, Dr. Tang initially judged that Mrs. Zhang was more likely to suffer from otolithiasis, but a special examination was still needed to confirm the diagnosis: otolithiasis.
Otolith examination
Mrs. Zhang came to the otolith examination room and was startled by a large machine that entered the door. It looked like the kind of training astronauts on TV. Space chair for balance.
After seeing Mrs. Zhang’s medical history, Dr. Tian, who was in charge of the otolith examination, instructed her to sit on a chair and told her not to. When you are nervous, the chair will turn a few positions to see if it can induce dizziness. If you experience dizziness during the chair rotation, don’t be too afraid. It usually lasts no more than one minute. If you want to vomit, tell me in time. Stop checking immediately and let her rest.
This test is the gold standard for diagnosing otolithiasis. The most important point is to keep your eyes open all the time; even if dizziness occurs, you should keep your eyes wide open. Determine whether the patient has otolithiasis.
According to the doctor’s instructions, Mrs. Zhang conducted an examination. Within a few seconds of the “Space Chair” falling to the right and back, Mrs. Zhang felt that the world was spinning; the doctor let Mrs. Zhang relax and opened her eyes for the doctor to see. Go in the direction of the eye roll and ask her if she feels nauseous and if she wants to vomit. After several repeated examinations, Dr. Tian diagnosed that Mrs. Zhang really had otolithiasis, and the examination results showed that the otolith in her right posterior semicircular canal fell out.
Repositioning treatment for otolithiasis
Otolithiasis is a benign disease, just like a cold, most people will recover slowly after rest, it is the length of time Questions can be as short as a few days or as long as a few months.
There is also a special reset treatment method for otolithiasis, which is a bit like checking otolithiasis. You need to sit on a swivel chair and rotate through certain rules to make the otolithiasis return to the place where it should stay. During the process of resetting, the feeling of spinning around the world like the one that happened during the inspection may occur many times, so be mentally prepared to see if you can bear it.
In addition, reduction is not 100% successful, and a small number of patients are not sensitive to reduction and may not be able to return. In addition, otolithiasis has the possibility of recurrence. Even if the reduction is successful this time, there is no guarantee that it will not recur in the future.
After careful consideration, Mrs. Zhang chose to undergo repositioning therapy. Fortunately, after Dr. Tian’s treatment, Mrs. Zhang succeeded in repositioning at one time. After the treatment, Dr. Tian instructed Mrs. Zhang to still pay attention to the following points:
All movements of the head in a short period of time should be as slow as possible, such as raising the head to dry the clothes, lowering the head to tie the shoelaces and turning the head. , especially when someone calls you, don’t turn your head suddenly, it is best to turn your body slowly and don’t turn your head; The feeling of softness can be improved by asking the attending doctor to prescribe medicine in the outpatient department. Pay attention to rest, and such symptoms will gradually disappear; Operation reset may be self-defeating.
Warm reminder
Mrs. Zhang’s strange problem that has been bothering her for a long time has been found out and solved. Under what circumstances is vertigo possibly otolithiasis? Come and compare with Mrs. Zhang’s experience. If necessary, be sure to come to the hospital and ask a professional doctor for examination and treatment~~
Review: Hu Haiyan