Jacot E, Wiener-Vacher S
Robert Debre Hospital, ORL Department, Vestibulometry Unit, Paris, France.
J Vestib Res. 2008;18(4):231-7.
Showing the interest of vestibular evoked myogenic potentials in paediatric neurological vestibulospinal pathology detection and followup.
The vestibular evoked myogenic potentials testing apparatus presented is now commonly used in ENT clinics for patients from 1 month of age. Our system and protocol permits control to evoke and select the best EMG level and makes possible a comparison of data from different sides or level of stimulation or different sessions. Normal vestibular evoked myogenic potentials latencies obtained with tone bursts were remarkably stable (P: 13 +/- 0.8 ms, N: 19.6 +/- 1.6 ms). The reported case illustrates abnormal vestibular evoked myogenic potentials latencies in neuropathy.
A 6 y.o. child with progressive imbalance was referred to the ENT department for vestibular functional evaluation. Abnormally long latencies in the vestibular evoked myogenic potentials and neurological examination oriented the diagnosis towards Guillain-Barre syndrome and immediate referral to a neurology department. Vestibular evoked myogenic potentials also helped to monitor the neurological recovery.
The present case shows the potential value of vestibular evoked myogenic potentials in diagnosis and evaluation of descending brainstem pathways in neuropathies like Guillain-Barre syndrome in complement to neurological evaluation.
展示前庭诱发肌源性电位在小儿神经前庭脊髓病变检测及随访中的应用价值。
所介绍的前庭诱发肌源性电位测试设备目前常用于耳鼻喉科诊所,适用于1个月大的患者。我们的系统和方案允许控制诱发并选择最佳肌电图水平,还能对来自不同侧别、刺激水平或不同检查时段的数据进行比较。使用短纯音获得的正常前庭诱发肌源性电位潜伏期非常稳定(P波:13±0.8毫秒,N波:19.6±1.6毫秒)。报告的病例说明了神经病变中前庭诱发肌源性电位潜伏期异常的情况。
一名6岁患有进行性平衡失调的儿童被转诊至耳鼻喉科进行前庭功能评估。前庭诱发肌源性电位潜伏期异常延长以及神经检查结果提示诊断为吉兰 - 巴雷综合征,并立即转诊至神经内科。前庭诱发肌源性电位也有助于监测神经恢复情况。
本病例显示了前庭诱发肌源性电位在诊断和评估吉兰 - 巴雷综合征等神经病变中下行脑干通路方面的潜在价值,可作为神经评估的补充手段。