geriatrРоссийский журнал гериатрической медициныRussian Journal of Geriatric Medicine2686-86362686-8709Сайт издателя10.37586/2686-8636-1-2022-37-42geriatr-241Research ArticleОБЗОРЫREVIEWSДоброкачественное пароксизмальное позиционное головокружение в пожилом возрастеBenign paroxysmal positional vertigo in the older adultshttps://orcid.org/0000-0002-0193-2243ЗамерградМ. В.ZamergradM. V.

д-р мед. наук, профессор кафедры неврологии с курсом рефлексологии и мануальной терапиителефон: +7(916)605-25-63

Москва

MD, PhD, professor, Department of Neurology with a course of reflexology and manual therapy

+7(916)605-25-63 

Moscow

zamergrad@gmail.comhttps://orcid.org/0000-0003-2643-2699МасуеваС. С.MasuevaS. S.

аспирант, врач-невролог 

Москва

 MD

Moscow

masuevas@mail.ruФГБОУ ДПО РМАНПО Минздрава России, Кафедра неврологии с курсом рефлексологии и мануальной терапии; ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России, Российский геронтологический научно-клинический центрРоссияRussian Medical Academy of Continuous Professional Education; Pirogov Russian National Research Medical UniversityRussian FederationФГБОУ ДПО РМАНПО Минздрава России, Кафедра неврологии с курсом рефлексологии и мануальной терапииРоссияRussian Medical Academy of Continuous Professional EducationRussian Federation202224052022013742Copyright © Замерград М.В., Масуева С.С., 20222022Замерград М.В., Масуева С.С.Zamergrad M.V., Masueva S.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.geriatr-news.com/jour/article/view/241

Доброкачественное пароксизмальное позиционное головокружение (ДППГ) представляет собой одну из самых частых причин головокружения. Распространенность этого заболевания нарастает с возрастом. Клинические проявления, характер течения заболевания и подходы к лечению в пожилом возрасте имеют свои особенности. Среди главных клинических особенностей ДППГ в пожилом возрасте — нередкое преобладание персистирующей неустойчивости над типичными эпизодами позиционного головокружения, а также склонность к хронизации. Особенности течения сводятся к большей частоте рецидивов, что объясняется продолжающимися дегенеративными процессами в отолитовой мембране преддверья лабиринта и сопутствующими заболеваниями, ограничивающими физическую активность и способствующими малоподвижному образу жизни. Лечение ДППГ в пожилом возрасте может быть затруднено из-за технических сложностей при проведении лечебных репозиционных маневров, также обусловленных сопутствующими заболеваниями и недостаточной подвижностью пациентов. Тем не менее в большинстве случаев лечение ДППГ в пожилом возрасте остается высокоэффективным, что делает особенно важным своевременное выявление этого заболевания, даже при атипичных клинических проявлениях. Основу диагностики ДППГ составляют позиционные пробы, которые должны проводиться при любых жалобах на головокружение и неустойчивость в пожилом возрасте.

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo. The prevalence of the disease increases with age. Course of the disease, clinical manifestations, and treatment approaches at older ages have their own characteristics. Frequent predominance of persistent instability over classic episodes of positional vertigo as well as tendency to chronicity are among the main clinical features of BPPV at advanced age. BPPV in the older adults has a higher frequency of relapses, which is explained by the continuing degenerative processes in the otolith membrane and concomitant diseases that limit physical activity of older patients. The BPPV treatment in the older can be difficult due to the technical problems during canalith repositioning procedures, concomitant diseases and insufficient mobility of patients. Nevertheless, in most cases, the treatment of BPPV in the older adults remains highly effective, which makes early-stage disease detection of great value, even with atypical clinical manifestations. Therefore, it is especially important to perform positional tests in any cases with complaints of dizziness and instability.

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The authors declare that there are no conflicts of interest present.