Xu K X, Chen T S, Wang W, Li S S, Wen C, Liu Q, Han X, Lin P
Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, 300192, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Jul 20;31(14):1075-1077. doi: 10.13201/j.issn.1001-1781.2017.14.005.
Analysis of vestibular ocular reflex (VOR) in patients with vestibular migraine (VM) by vestibular autorotation test (VAT). To explore the clinical value of VAT technology in the diagnosis of vestibular migraine.Sixty-nine patients with VM, 73 patients with posterior circulation (PCI) vertigo and 65 normal people were examined by VAT test. The characteristics of vestibular ocular reflex were analyzed by using VAT gain, phase and asymmetry among them.①Among the 69 cases of VM patients,54 cases (78.3%) were horizontal or vertical gain abnormalities, 66 cases (95.7%) were horizontal or/and vertical phase delay, and 13 cases (18.8%) were asymmetric abnormalities. ②Among the 54 (78.3%) cases of abnormal gain, 46 (66.7%) cases demonstrated high gain, 42 had high gain combined with high phase, and 36 cases were simple horizontal high gain (and mainly concentrated at 2-4 Hz, 26 cases), 8 cases (11.6%) showed low gain. ③VAT characteristics in PCI group:47 cases (64.4%) were high gain, and 11 cases (15.1%) were low gain. There was no significant difference in high gain and low gain between PCI group and VM group (χ² was 0.07 and 0.37, >0.05). Both VM group and PCI group are high-gain, but there was significant difference in the phase delay and asymmetric indicators. ④VAT characteristics in normal people group: The four indices have low abnormally positive rates. There were statistically significant differences of the high gain and the low gain between the normal people group and VM group(χ² were 56.17 and 97.57, <0.01).The vestibular ocular reflex of VM is high-gain based and was mostly in the 2-4 Hz frequency,and accompanied by phase delay. Vestibular central system was mainly involved in VM. VAT detection can provide a clue for VM diagnostics.
通过前庭自旋转试验（VAT）分析前庭性偏头痛（VM）患者的前庭眼反射（VOR）。探讨VAT技术在前庭性偏头痛诊断中的临床价值。对69例VM患者、73例后循环（PCI）眩晕患者和65名正常人进行VAT测试。利用VAT增益、相位及其不对称性分析前庭眼反射的特征。①69例VM患者中，54例（78.3%）水平或垂直增益异常，66例（95.7%）水平或/和垂直相位延迟，13例（18.8%）不对称异常。②在54例（78.3%）增益异常的病例中，46例（66.7%）表现为高增益，42例高增益合并高相位，36例为单纯水平高增益（主要集中在2 - 4Hz，26例），8例（11.6%）表现为低增益。③PCI组的VAT特征：47例（64.4%）为高增益，11例（15.1%）为低增益。PCI组与VM组高增益和低增益差异无统计学意义（χ²分别为0.07和0.37，>0.05）。VM组和PCI组均为高增益，但相位延迟和不对称指标差异有统计学意义。④正常人群组的VAT特征：四项指标异常阳性率低。正常人群组与VM组高增益和低增益差异有统计学意义（χ²分别为56.17和97.57，<0.01）。VM的前庭眼反射以高增益为主，多在2 - 4Hz频率，且伴有相位延迟。VM主要累及前庭中枢系统。VAT检测可为VM诊断提供线索。
