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眼和颈前庭诱发肌源性电位在偏头痛性眩晕患者中的应用。

Ocular and Cervical Vestibular Evoked Myogenic Potentials in Patients With Vestibular Migraine.

机构信息

Department of Hearing and Speech Sciences, Division of Vestibular Sciences, Vanderbilt University Medical Center, Nashville, TN.

Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA.

出版信息

Otol Neurotol. 2018 Aug;39(7):e561-e567. doi: 10.1097/MAO.0000000000001880.

Abstract

OBJECTIVE

To evaluate the relationship between normal and abnormal ocular vestibular evoked myogenic potentials (oVEMP) and cervical vestibular evoked myogenic potentials (cVEMP) in patients with and without vestibular migraine (VM).

STUDY DESIGN

Retrospective review of oVEMP and cVEMP results in patients with vestibular disorders who were assessed clinically and completed vestibular function studies. Data were extracted from a deidentified RedCap Repository.

SETTING

Tertiary care multispecialty medical center.

PATIENTS

Subjects were 212 consecutive adults meeting prespecified inclusion criteria who were evaluated in the Balance Disorders Clinic at Vanderbilt University Medical Center between 2011 and 2017. Patients with bilaterally absent VEMPs were excluded from the study.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Proportions of subjects with or without VM in one of the following four test outcomes: normal cVEMP/normal oVEMP, abnormal cVEMP/abnormal oVEMP, abnormal cVEMP/normal oVEMP, and normal cVEMP/abnormal oVEMP.

RESULTS

There was a significant relationship between VM and cVEMP and oVEMP test outcomes.

CONCLUSION

Patients with VM are more likely than subjects with vestibular disorders other than migraine to exhibit normal cVEMP responses in the presence of unilaterally abnormal oVEMP responses. Such a VEMP pattern may be a biomarker of VM and further supports a possible pathophysiologic relationship between the utriculo-ocular reflex and VM.

摘要

目的

评估伴有和不伴有前庭性偏头痛(VM)的患者的正常和异常眼震前庭诱发肌源性电位(oVEMP)与颈性前庭诱发肌源性电位(cVEMP)之间的关系。

研究设计

回顾性分析了在临床评估和完成前庭功能研究的前庭疾病患者的 oVEMP 和 cVEMP 结果。数据从一个匿名的 RedCap 存储库中提取。

地点

三级保健多专科医疗中心。

患者

2011 年至 2017 年期间,在范德比尔特大学医学中心的平衡障碍诊所评估了 212 例符合特定纳入标准的连续成年患者。双侧 VEMP 缺失的患者被排除在研究之外。

干预措施

无。

主要观察指标

以下四种测试结果中有无 VM 的患者比例:正常 cVEMP/正常 oVEMP、异常 cVEMP/异常 oVEMP、异常 cVEMP/正常 oVEMP 和正常 cVEMP/异常 oVEMP。

结果

VM 与 cVEMP 和 oVEMP 测试结果之间存在显著关系。

结论

与偏头痛以外的前庭疾病患者相比,VM 患者更有可能在单侧 oVEMP 反应异常的情况下出现正常的 cVEMP 反应。这种 VEMP 模式可能是 VM 的生物标志物,并进一步支持了耳石-眼反射和 VM 之间可能存在的病理生理关系。

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