Transcription of 良性発作性頭位変換性眩暈（BPPV）、NEJM March 20,2014
1 1 / 16 BPPV NEJM March 20,2014 Benign Paroxysmal Positional Vertigo Clinical Practice Ji-Soo Kim, David , Johns Hopkins University CBR 1 1 ( CBR ) CBR 40 1 1100 3 ML NEJM March20,2014 Clinical Practice BPPV Ji-Soo Kim Johns Hopkins University David BPPV Epley 58 1 BPPV Epley Epley 2 / 16 BPPV 7 17 Epley Canalith-repositioning maneuver Epley 1992 BPPV Epley
2 Epley NEJM Epley Semont BBQ Gufoni BPPV 1 BPPV BPPV stroke BPPV 1 30 ALT assistant language teacher vomit regurgitate throw up Where is a washroom?
3 3 / 16 BPPV BPPV 50 60 1 2 1 3 15 osteopenia osteoporosis D D BPPV 90 Shall we dance? ALT BPPV macula 60 90 BPPV 30 GP BPPV Ewald s 1st law BPPV stroke vestibular migraine Stroke
4 Vertical misalignment 4 / 16 Stroke head-impulse head thrust test Head-impulse test saccade ( ) head-impulse test; saccade Doll s head eye phenomenon Doll s head eye OK III IV VI head-impulse test stroke spontaneous 30 BPPV 3 ON
5 Head-impulse test 5 / 16 NST NST 20 Vestibular migraine motion sickeness BPPV cupula ( ) ~t- 2 BPPV 45 30 cupula hair cell ampulla ( ) ampulla ampullopetal 20 ampullofugal Fuga Refugee( ) ( )
6 6 / 16 BPPV Epley 30 30 cupula ( ) ampula ( ) cupula ampullopetal: ampullfugal : Ewald s 2nd law Cupula cup 007 cupula 1962 cupula 100 60 7 / 16 BTLS
7 Basic Trauma Life Support 1977 11 15 18 35 1km 11 15 30 2002 1978 4 2 2 BPPV Dix-Hallpike Epley BPPV Dix-Hallpike Epley Dix-Hallpike NEJM Dr.
8 Peter Johns How to do the Epley Maneuver Dr. Peter Jones BPPV 8 / 16 Dix-Hallpike 1 12 20 45 Dix-Hallpike 1 48 20 45 BPPV upward nystagmus Dix-Hallpike BPPV BPPV
9 Upward nystagmus BPPV 2 5 1 30 cupula cupulolithiasis cupula 9 / 16 3 Hi Dix-Hallpike Epley 2 38 NEJM 30 2 Epley Dix-Hallpike 20 45 45 90 2 135 2 10 Dr.
10 Peter Johns Dix- Hallpike Epley 5 10 Epley1 80 4 92 Dix-Hallpike 1 2 Epley Dix-Hallpike 15 3 Epley 15 3 3 sham maneuver Epley 95%CI, BPPV Semont BPPV Semont BPPV Epley BPPV Semont 180
