Guan Qiongfeng, Zhang Lisan, Hong Wenke, Yang Yi, Chen Zhaoying, Zhang Dan, Hu Xingyue
Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310020, China; Department of Neurology, Ningbo Second Hospital, Ningbo 315001, China.
Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310020, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2017 Jan 25;46(1):52-58. doi: 10.3785/j.issn.1008-9292.2017.02.08.
To assess the clinical application of video head impulse test (vHIT) for vestibular function in vestibular neuritis (VN) and benign paroxysmal positional vertigo (BPPV) patients. Thirty-three patients with VN and 43 patients with BPPV were enrolled from Sir Run Run Shaw Hospital and Ningbo Second Hospital from March 15 to September 10, 2015; and 50 healthy controls were also enrolled in the study. vHIT was used to quantitatively test the vestibulo-ocular reflex (VOR) gains of a pair of horizontal semicircular canals. VOR gains two pairs of vertical semicircular canals, and the corresponding asymmetrical value of three VOR gains. The saccades information was also recorded. Compared with the healthy control group and BPPV patients, the affected horizontal and vertical VOR gains were declined and the corresponding asymmetries were increased in VN patients (all <0.01). BPPV group also showed higher vertical VOR gain asymmetries compared with the healthy control group (all <0.01), but no significant difference was observed in VOR gains and horizontal VOR gain asymmetry (all >0.05). The sensibility of vHIT in diagnosis of VN was 87.9%. Among 33 VN patients, 22 were diagnosed with superior vestibular nerve dysfunction, 7 were found with inferior vestibular nerve dysfunction and 3 were with both dysfunction; and 1 case was not distinguished. Video head impulse test can quantitatively evaluate the vestibular dysfunction of VN and can help early diagnosis of VN, which may be widely used in clinic.
评估视频头脉冲试验（vHIT）在前庭神经炎（VN）和良性阵发性位置性眩晕（BPPV）患者前庭功能中的临床应用。2015年3月15日至9月10日，从浙江大学医学院附属邵逸夫医院和宁波市第二医院招募了33例VN患者和43例BPPV患者；并招募了50名健康对照者纳入研究。使用vHIT定量测试一对水平半规管的前庭眼反射（VOR）增益、两对垂直半规管的VOR增益以及三个VOR增益的相应不对称值。还记录了扫视信息。与健康对照组和BPPV患者相比，VN患者患侧的水平和垂直VOR增益下降，相应的不对称性增加（均P<0.01）。BPPV组与健康对照组相比，垂直VOR增益不对称性也更高（均P<0.01），但VOR增益和水平VOR增益不对称性无显著差异（均P>0.05）。vHIT诊断VN的敏感度为87.9%。33例VN患者中，22例被诊断为前庭上神经功能障碍，7例为前庭下神经功能障碍，3例两者均有功能障碍；1例未明确区分。视频头脉冲试验可定量评估VN的前庭功能障碍，有助于VN的早期诊断，可能在临床上得到广泛应用。
