Liu W Y, Chen T S, Wang W, Xu K X, Li S S, Wen C, Liu Q, Lin P
First Center Clinic College,Tianjin Medical University,Tianjin,300192,China.
Tianjin Institute of Otolaryngology,Department of Otolaryngology-Head and Neck Surgery,the First Central Hospital of Tianjin.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 May 5;31(9):678-681. doi: 10.13201/j.issn.1001-1781.2017.09.007.
To study the characteristics and clinical value of spontaneous nystagmus in patients with peripheral vestibular dysfunction.Sixty cases with acute unilateral peripheral vestibular dysfunction were studied.All were diagnozed as vestibular neuritis(VN) . The relationship between SN and disease duration,DP and UW were analyzed.SN was present in49 patients(81.7%)and absent in the remaining 11(18.3%).The intensity of SN ranged from 0.5°/s-20.4°/s and had negative correlation with the disease duration(=-0.478，<0.01). The patients were divided into 3 groups (mild,medium and severe) according to SN intensity,with median duration of disease being 6.5 d，5 d and 3 d respectively. The difference between groups was statistically significant(²=9.071，<0.01).The result of the caloric test were as following：caloric test revealed DP in 44 cases（89.8%） of SN ;DP values were normal in 8 cases（10.2%）;SN intensity was positively correlated with DP value（=0.513,<0.01） ;unilateral weakness was found in 35 cases（71.4%）,with the direction of SN towards the weakness side in 4 cases and towards the opposite direction in the remaining 31 cases; 7 cases（14.3%）had bilateral weakness and 7 cases（14.3%）normal. There were no relationship between the intensity of SN and UW value（=-0.321,>0.05）.The UW value of patients with SN (40.9±26.3）% was compared to the group without SN（29.9±18.2）% . The difference was statistically significant (=4.497,<0.05).The intensity of SN in patients with acute unilateral peripheral vestibular dysfunction was often moderate and severe. The intensity of SN waned as the disease progressed or the direction reversed,The vestibular injury in patient with SN was more severe than those without. SN is useful in clinical assessment of vestibular injury and compensatory status.
研究外周前庭功能障碍患者自发性眼震的特征及临床价值。对60例急性单侧外周前庭功能障碍患者进行研究。所有患者均被诊断为前庭神经炎（VN）。分析自发性眼震（SN）与病程、冷热试验眼震慢相角速度（DP）及优势眼（UW）的关系。49例患者（81.7%）出现SN，其余11例（18.3%）未出现。SN强度范围为0.5°/秒至20.4°/秒，且与病程呈负相关（r = -0.478，P < 0.01）。根据SN强度将患者分为3组（轻度、中度和重度），疾病中位病程分别为6.5天、5天和3天。组间差异具有统计学意义（χ² = 9.071，P < 0.01）。冷热试验结果如下：冷热试验显示，44例（89.8%）有SN的患者出现DP；8例（10.2%）DP值正常；SN强度与DP值呈正相关（r = 0.513，P < 0.01）；35例（71.4%）出现单侧眼震减弱，其中4例SN方向朝向眼震减弱侧，其余31例朝向相反方向；7例（14.3%）出现双侧眼震减弱，7例（14.3%）正常。SN强度与UW值无相关性（r = -0.321，P > 0.05）。出现SN的患者UW值为（40.9±26.3）%，与未出现SN的组（29.9±18.2）%相比，差异具有统计学意义（t = 4.497，P < 0.05）。急性单侧外周前庭功能障碍患者的SN强度常为中度和重度。随着疾病进展，SN强度减弱或方向逆转，有SN的患者前庭损伤比无SN的患者更严重。SN有助于前庭损伤及代偿状态的临床评估。
