关键词: 眩晕, 神经, 前庭, 针刺, 康复, 药物, 梅尼埃病, 良性阵发性位置性眩晕, 偏头痛

Abstract: BACKGROUND: Vertigo is closely related to clinical neurological disorders. When neurons are damaged or dead, it may lead to abnormalities in the vestibular system and trigger vertigo symptoms. Therefore, it is necessary to explore and analyze the hotspots related to vertigo that are common in clinical neurology.
OBJECTIVE: To analyze the vertigo-related histopathological changes in clinical neurology and the research hotspots worldwide using bibliometric methods.
METHODS: The WanFang database and Web of Science core set database were searched by the first author to retrieve the research-related literature published from 2014-2023 on the treatment of common vertigo in clinical neurology. A bibliometric analysis of the number of publications, country/region, institution, keywords, co-cited literature, and highly cited literature was peformed using VOSviewer_1.6.19 software to summarize the research hotspots in this research field. 
RESULTS AND CONCLUSION: Web of Science core set database had the highest number of 174 publications in this field in 2022, and WanFang database had the highest number of 133 publications in this field in 2020. The top 3 countries with the highest number of publications are the United States, Germany, and China. The University of Munich, Germany is the international institution with the highest number of publications in this field, while Chengdu University of Traditional Chinese Medicine is the Chinese institution with the highest number of publications in this field. The results of keyword analysis showed that the research hotspot diseases in this field in China are mainly Meniere’s disease, cervical vertigo, senile vertigo, benign paroxysmal positional vertigo, isolated vertigo, and hypertensive vertigo, and the treatments include acupuncture, rehabilitation, medication (gastrodin, Banxia Baizhu Tianma Tang), and manipulative reduction. International research hotspot diseases in this field mainly include benign paroxysmal positional vertigo, vestibular disorders in new coronavirus cases, Meniere’s disease, vestibular schwannoma, acoustic neuromas, and vestibular migraines, etc., and the hotspot treatments are antivertiginous medications, antidepressant and anxiolytic treatments, and microsurgery. The results of literature co-citation analysis showed that for acute vestibular syndrome with persistent vertigo as the main symptom, three-step bedside ophthalmoscopy (HINTS: Head-Impact-Nystagmus-Strabismus Test) is more sensitive than early MRI in the diagnosis of combined strokes in patients with acute vestibular syndrome, which is the most peer-recognized method of detecting strokes in vestibular syndrome, whereas hormonal therapy is more effective to treat vestibular neuritis patients with paroxysmal vertigo as the main symptom. The results of highly cited literature analysis showed that, in the hot literature included in WanFang database in the past 10 years, acupuncture at Fengchi point and the acupuncture method of inducing resuscitation to improve posterior circulation ischemic vertigo have achieved certain results. The literature published in the past 3 years has indicated that Ginkgo biloba leaf extract+gastrodin, acupuncture+Banxia Baizhu Tang, betahistine+gastrodin, vestibular rehabilitation training+Epley Maneuver, all can improve the vertigo symptoms to different degrees. While there were no featured anti-vertigo drugs indicated in the literature in the Web of Science core set data in the recent 10 years, and most of them are based on traditional anti-vertigo drugs and microsurgery. However, there are a few case reports in the international literature in the last 3 years that found that COVID-19 infection may lead to vestibular neuritis and vertigo symptoms.  The onset and progression of vertigo may be closely related to neuronal damage and regeneration. For example, viral infections, inflammatory stimuli, or other pathologic factors may lead to neuronal damage or death, thereby affecting the function of the vestibular system. Vertigo-related diagnosis and treatment standardization guidelines have been published both domestically and internationally. Currently, international guidelines recommend the combination of vestibular rehabilitation and physical rehabilitation for the treatment of vertigo, and Chinese guidelines recommend the combination of Chinese and Western medicine, reduction and acupuncture. However, the level of evidence is not very high, so a large number of large-sample, multicenter randomized controlled trials on anti-vertigo treatment are needed in the future.

Key words: vertigo, nerve, vestibule, acupuncture, rehabilitation, drug, Meniere’s disease, benign paroxysmal positional vertigo, migraine headache