Maria da Silva Lira-Batista Marta, Schaffeln Dorigueto Ricardo, Freitas Ganança Cristina
Resident in Multiprofessional Hospital Care (concentration area: Adult and Elderly), University Federal of São Paulo UNIFESP. Speech Therapist.
Doctorate in Science from the Federal University of São Paulo. Member of the Brazilian Society of Otolaryngology.
Int Arch Otorhinolaryngol. 2013 Apr;17(2):147-56. doi: 10.7162/S1809-97772013000200006.
Benign Paroxysmal Positional Vertigo (BPPV) is a very common vestibular disorder characterized by brief but intense attacks of rotatory vertigo triggered by simple rapid movement of the head. The integrity of the vestibular pathways can be assessed using tests such as digital vectoelectronystagmography (VENG) and vestibular evoked myogenic potentials (VEMP).
This study aimed to determine the VEMP findings with respect to latency, amplitude, and waveform peak to peak and the results of the oculomotor and vestibular components of VENG in patients with BPPV.
Although this otoneurological condition is quite common, little is known of the associated VEMP and VENG changes, making it important to research and describe these results.
We examined the records of 4438 patients and selected 35 charts after applying the inclusion and exclusion criteria. Of these, 26 patients were women and 9 men. The average age at diagnosis was 52.7 years, and the most prevalent physiological cause, accounting for 97.3% of cases, was ductolithiasis. There was a statistically significant association between normal hearing and mild contralateral sensorineural hearing loss. The results of the oculomotor tests were within the normal reference ranges for all subjects. Patients with BPPV exhibited symmetrical function of the semicircular canals in their synergistic pairs (p < 0.001). The caloric test showed statistically normal responses from the lateral canals. The waveforms of all patients were adequate, but the VEMP results for the data-crossing maneuver with positive positioning showed a trend toward a relationship for the left ear Lp13. There was also a trend towards an association between normal reflexes in the caloric test and the inter-peak VEMP of the left ear. It can be concluded that although there are some differences between the average levels of the VENG and VEMP results, these differences were not statistically significant.
In conclusion, the results of audiologic assessment, hearing thresholds, positioning maneuvers, and caloric tests have no effect on the quantitative results of VEMP. Additional research is warranted to establish the relationships among VENG, VEMP, and BPPV, especially as concerns the oculomotor tests.
良性阵发性位置性眩晕(BPPV)是一种非常常见的前庭疾病,其特征是头部简单快速运动引发短暂但强烈的旋转性眩晕发作。前庭通路的完整性可通过数字矢量眼震电图(VENG)和前庭诱发肌源性电位(VEMP)等测试进行评估。
本研究旨在确定BPPV患者VEMP在潜伏期、振幅和峰峰值方面的结果以及VENG的眼动和前庭成分的结果。
尽管这种耳神经科疾病相当常见,但对相关的VEMP和VENG变化知之甚少,因此研究和描述这些结果很重要。
我们检查了4438例患者的记录,并在应用纳入和排除标准后选择了35份病历。其中,女性26例,男性9例。诊断时的平均年龄为52.7岁,最常见的生理原因是耳石症,占病例的97.3%。正常听力与轻度对侧感音神经性听力损失之间存在统计学上的显著关联。所有受试者的眼动测试结果均在正常参考范围内。BPPV患者协同对中的半规管功能对称(p < 0.001)。冷热试验显示外侧半规管反应在统计学上正常。所有患者的波形都足够,但阳性定位数据交叉操作的VEMP结果显示左耳Lp13有相关趋势。冷热试验中的正常反射与左耳VEMP峰间值之间也有相关趋势。可以得出结论,尽管VENG和VEMP结果的平均水平存在一些差异,但这些差异在统计学上并不显著。
总之,听力评估、听力阈值、定位操作和冷热试验的结果对VEMP的定量结果没有影响。有必要进行进一步研究以确定VENG、VEMP和BPPV之间的关系,特别是关于眼动测试的关系。