Skóra Wojciech, Stańczyk Ramzes, Pajor Anna, Jozefowicz-Korczyńska Magdalena
Otolaryngology Department, S. Rybicki Memorial Regional Hospital in Skierniewice, Poland.
Balance Disorder Unit, Otolaryngology Department, Medical University of Lodz, Norbert Barlicki Memorial University Hospital No. 1, Poland.
Ann Agric Environ Med. 2018 Dec 20;25(4):665-668. doi: 10.26444/aaem/81138. Epub 2018 Feb 14.
In the literature there are some discrepancies concerning the occurrence of vertigo and disequilibrium, as well as the type of vestibular dysfunction in patients after mild traumatic brain injury (MTBI).
The aim of the study was to assess the type of vestibular system dysfunction in MTBI patients after injury at baseline and 6-month follow-up.
From a group of 188 patients with vertigo/dizziness and balance instability after MTBI, prospective analysis in 50 patients with abnormal videonystagmography (VNG) were conducted. Anamnesis, otoneurological examination, self-assessed Dizziness Handicap Inventory (DHI) and VNG test were carried in each patient twice - at baseline and after 6 months.
A significant improvement in the DHI total score (9.8 points, p<0.001) and in the subscales was found after 6 months. At baseline, VNG test showed the peripheral vestibular system dysfunction in 19 cases (38%), central vestibular dysfunction in 20 patients (40%) and mixed vestibular dysfunction in 11 cases (44%). After 6 months, the VNG records normalization was observed in 19 patients (38%), an improvement was significantly more frequently related to peripheral disorders, compared to central ones (p,0.001).
In patients after mild traumatic brain injury, about one-fourth of them had vestibular system dysfunction with the same frequency of peripheral, central and mixed lesions in videonystagmography. Subjective post-traumatic symptoms and vestibular system dysfunction in patients after MTBI decrease after 6-month follow-up. However, more than half of patients still have abnormal VNG results, which indicate dysfunction of the central vestibular system.
在文献中，关于轻度创伤性脑损伤（MTBI）患者眩晕和失衡的发生率以及前庭功能障碍的类型存在一些差异。
本研究的目的是评估MTBI患者在受伤后基线和6个月随访时前庭系统功能障碍的类型。
从188例MTBI后出现眩晕/头晕和平衡不稳的患者中，对50例视频眼震图（VNG）异常的患者进行前瞻性分析。对每位患者进行两次问诊、耳神经学检查、自我评估的头晕残障量表（DHI）和VNG测试——一次在基线时，一次在6个月后。
6个月后发现DHI总分（9.8分，p<0.001）及各子量表有显著改善。基线时，VNG测试显示19例（38%）为外周前庭系统功能障碍，20例（40%）为中枢前庭功能障碍，11例（22%）为混合性前庭功能障碍。6个月后，19例患者（38%）的VNG记录恢复正常，与中枢性疾病相比，外周性疾病的改善更为显著（p<0.001）。
在轻度创伤性脑损伤患者中，约四分之一的患者存在前庭系统功能障碍，在视频眼震图中外周、中枢和混合性病变的发生率相同。MTBI患者创伤后的主观症状和前庭系统功能障碍在6个月随访后有所减轻。然而，超过一半的患者VNG结果仍异常，这表明中枢前庭系统功能障碍。
