Mantokoudis Georgios, Saber Tehrani Ali S, Kattah Jorge C, Eibenberger Karin, Guede Cynthia I, Zee David S, Newman-Toker David E
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Md., USA.
Audiol Neurootol. 2015;20(1):39-50. doi: 10.1159/000362780. Epub 2014 Dec 9.
Video-oculography devices are now used to quantify the vestibulo-ocular reflex (VOR) at the bedside using the head impulse test (HIT). Little is known about the impact of disruptive phenomena (e.g. corrective saccades, nystagmus, fixation losses, eye-blink artifacts) on quantitative VOR assessment in acute vertigo. This study systematically characterized the frequency, nature, and impact of artifacts on HIT VOR measures. From a prospective study of 26 patients with acute vestibular syndrome (16 vestibular neuritis, 10 stroke), we classified findings using a structured coding manual. Of 1,358 individual HIT traces, 72% had abnormal disruptive saccades, 44% had at least one artifact, and 42% were uninterpretable. Physicians using quantitative recording devices to measure head impulse VOR responses for clinical diagnosis should be aware of the potential impact of disruptive eye movements and measurement artifacts.
视频眼动描记设备现在用于床边通过头脉冲试验（HIT）对前庭眼反射（VOR）进行量化。关于干扰现象（如矫正性扫视、眼球震颤、注视丢失、眨眼伪迹）对急性眩晕中VOR定量评估的影响，人们了解甚少。本研究系统地描述了伪迹在HIT VOR测量中的频率、性质和影响。在一项对26例急性前庭综合征患者（16例前庭神经炎、10例中风）的前瞻性研究中，我们使用结构化编码手册对结果进行分类。在1358条单独的HIT记录中，72%有异常的干扰性扫视，44%至少有一个伪迹，42%无法解读。使用定量记录设备测量头脉冲VOR反应以进行临床诊断的医生应意识到干扰性眼动和测量伪迹的潜在影响。
