Takahashi S, Fetter M, Koenig E, Dichgans J
Eberhard-Karls-University, Department of Neurology, Tübingen, FRG.
Acta Otolaryngol. 1990 Jan-Feb;109(1-2):8-14. doi: 10.3109/00016489009107409.
The clinical significance of horizontal head-shaking nystagmus (HSN) was evaluated in 85 patients who complained of dizziness and vertigo. This was done by comparison of the horizontal head-shaking test with routine rotatory and caloric vestibular testing. We found that HSN evoked by horizontal head-shaking is a highly sensitive way to detect unilateral vestibular hypofunction. Except in patients with additional central vestibular imbalance or in patients with Meniere's disease, the direction of horizontal HSN is highly significant in indicating the side of the lesion, with the fast phase beating toward the intact side. However, horizontal HSN is not specific in distinguishing peripheral hypofunction from more central vestibular imbalances. Peripheral vestibular hypofunction as well as a central asymmetry of the vestibular velocity storage mechanism can each separately or in combination produce horizontal HSN. Thus, while the head-shaking manoeuvre is an excellent bedside-test to detect unilateral vestibular hypofunction, further rotatory and caloric testing is still necessary to clarify the patient's condition.
对85例主诉头晕和眩晕的患者评估了水平摇头性眼震（HSN）的临床意义。通过将水平摇头试验与常规旋转和冷热前庭试验进行比较来完成此项评估。我们发现，水平摇头诱发的HSN是检测单侧前庭功能减退的一种高度敏感的方法。除了伴有额外中枢性前庭失衡的患者或梅尼埃病患者外，水平HSN的方向在指示病变侧方面具有高度显著性，快相指向健侧。然而，水平HSN在区分外周性功能减退与更中枢性的前庭失衡方面并不具有特异性。外周性前庭功能减退以及前庭速度存储机制的中枢性不对称均可单独或共同产生水平HSN。因此，虽然摇头动作是检测单侧前庭功能减退的一项出色的床边检查，但仍需要进一步的旋转和冷热试验来明确患者的病情。
