Department of Otolaryngology, Teikyo University School of Medicine, Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki 213-8507, Japan.
Neurosci Lett. 2013 Oct 11;553:95-8. doi: 10.1016/j.neulet.2013.08.002. Epub 2013 Aug 20.
The otolith-collic and otolith-ocular reflexes of patients who experienced episodic tilting or translational sensations in the pitch plane without any other vestibular symptoms were assessed using cervical vestibular evoked myogenic potentials (cVEMP) and ocular vestibular evoked myogenic potentials (oVEMP). Eleven patients (4 men and 7 women, mean age=40.4) were enrolled. All of the patients complained of episodic tilting or translational sensations in the pitch plane. Patients with a medical history of rotatory vertigo, loss of consciousness, head trauma, or symptoms of central nervous dysfunction or proprioceptive dysfunction and those who had been definitely diagnosed with a disease that causes disequilibrium were excluded. All 11 patients underwent cVEMP and caloric tests. Ten patients participated in the oVEMP tests. Seven of the 11 patients exhibited unilateral cVEMP absences, two displayed bilateral cVEMP absences, one demonstrated unilaterally decreased cVEMP, and one displayed normal cVEMP. Concerning oVEMP, 2 of the 10 patients showed unilateral oVEMP absences, 2 displayed bilateral oVEMP absences, 2 exhibited unilaterally decreased oVEMP, and 4 displayed normal oVEMP. All patients exhibited normal bilateral caloric responses. These findings were distinct from the results obtained for patients who experienced episodic lateral tilting sensations in previous studies. While most of the latter patients exhibited abnormal oVEMP, the patients in the present study tended to display abnormal cVEMP. These results suggest that patients with episodic tilting or translational sensations in the pitch plane suffer from saccular dysfunction. We propose "idiopathic otolithic vertigo" as a clinical entity and suggest that it is caused by idiopathic saccular dysfunction and/or utricular dysfunction.
对经历过俯仰平面间歇性倾斜或平移感觉但无其他前庭症状的患者的耳石-迷路和耳石-眼反射进行了评估，使用了颈性前庭诱发肌源性电位（cVEMP）和眼性前庭诱发肌源性电位（oVEMP）。共纳入 11 名患者（4 男 7 女，平均年龄 40.4 岁）。所有患者均主诉有俯仰平面间歇性倾斜或平移感觉。排除有旋转性眩晕、意识丧失、头部外伤或中枢神经系统功能障碍或本体感觉功能障碍症状病史或明确诊断为导致失衡疾病的患者。所有 11 名患者均接受了 cVEMP 和冷热试验。10 名患者参加了 oVEMP 测试。11 名患者中有 7 名出现单侧 cVEMP 缺失，2 名出现双侧 cVEMP 缺失，1 名表现为单侧 cVEMP 减少，1 名表现为正常 cVEMP。关于 oVEMP，10 名患者中有 2 名出现单侧 oVEMP 缺失，2 名出现双侧 oVEMP 缺失，2 名表现为单侧 oVEMP 减少，4 名表现为正常 oVEMP。所有患者双侧冷热反应均正常。这些发现与之前研究中经历间歇性侧向倾斜感觉的患者的结果不同。虽然大多数后者患者表现出异常的 oVEMP，但本研究中的患者倾向于表现出异常的 cVEMP。这些结果表明，经历俯仰平面间歇性倾斜或平移感觉的患者存在球囊功能障碍。我们提出“特发性耳石性眩晕”作为一种临床实体，并认为它是由特发性球囊功能障碍和/或椭圆囊功能障碍引起的。
