Krbot Skoric Magdalena, Adamec Ivan, Habek Mario
Department of Neurology, University Hospital Center Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia.
Neurol Sci. 2014 Oct;35(10):1599-602. doi: 10.1007/s10072-014-1847-9. Epub 2014 Jun 11.
The aim of the present study was to evaluate vestibular nerve involvement in patients with Bell's palsy with ocular and cervical vestibular evoked myogenic potentials (oVEMP and cVEMP). Ten patients who were diagnosed with Bell's palsy and ten healthy controls were included. All patients underwent VEMP recordings within 6 days after their initial presentation. Patients with Bell's palsy had greater oVEMP asymmetry ratio comparing to healthy controls (-38.4 ± 28.7 % vs -1.3 ± 19.3 %, p = 0.005). As well N10 latencies of the oVEMP response were prolonged comparing to healthy controls (11.575 vs 9.72 ms). There was no difference in cVEMP asymmetry ratio or latencies between groups. We found no correlation between House-Brackmann grading scale and oVEMP asymmetry ratio (r = 0.003, p = 0.994). There are three possible explanations for increased oVEMP amplitudes on the affected side: (1) oVEMP response on the ipsilateral eye could be contaminated by facial nerve activity (blink reflex); (2) the amplitude of N10-P33 could be affected through the stapedial reflex; and (3) increased oVEMP amplitude could be the consequence of the vestibular nerve dysfunction itself, with prolonged latencies of the N10 oVEMP further supporting this explanation. The results of this study indicate possible involvement of the superior branch of the vestibular nerve in patients with Bell's palsy.
本研究的目的是通过眼和颈前庭诱发肌源性电位(oVEMP和cVEMP)评估贝尔面瘫患者的前庭神经受累情况。纳入了10例被诊断为贝尔面瘫的患者和10名健康对照者。所有患者在首次就诊后6天内接受了VEMP记录。与健康对照者相比,贝尔面瘫患者的oVEMP不对称率更高(-38.4±28.7%对-1.3±19.3%,p = 0.005)。此外,与健康对照者相比,oVEMP反应的N10潜伏期延长(11.575对9.72 ms)。两组之间的cVEMP不对称率或潜伏期没有差异。我们发现House-Brackmann分级量表与oVEMP不对称率之间没有相关性(r = 0.003,p = 0.994)。患侧oVEMP振幅增加有三种可能的解释:(1)同侧眼的oVEMP反应可能被面神经活动(眨眼反射)污染;(2)N10-P33的振幅可能通过镫骨肌反射受到影响;(3)oVEMP振幅增加可能是前庭神经功能障碍本身的结果,N10 oVEMP潜伏期延长进一步支持了这一解释。本研究结果表明贝尔面瘫患者的前庭神经上支可能受累。