Vestibular Research Laboratory, School of Psychology, The University of Sydney, Sydney, NSW, Australia.
MSA ENT Academy Center - Cassino, Frosinone, Italy.
Semin Neurol. 2020 Feb;40(1):33-39. doi: 10.1055/s-0039-3402064. Epub 2019 Dec 30.
Recent advances in vestibular testing now permit functional testing of all peripheral vestibular sense organs (all three semicircular canals, utricle, and saccule). This makes it possible to identify patients with isolated dysfunction of the utricle or saccule, even though parallel pathways for vestibular information are ultimately integrated centrally. Selective, isolated unilateral loss of utricular function as measured by ocular vestibular-evoked myogenic potentials (VEMPs) has been observed in patients with normal semicircular canal function as measured by the video head impulse test of all six semicircular canals, and normal bilateral saccular function as determined by symmetrical cervical VEMPs. How these patients present clinically and how they recover is discussed and contrasted with acute vestibular neuritis. In some patients, the unilateral loss of otolith organ (utricle or saccule) function persists and yet the patient recovers functionally to their usual lifestyle. Until the testing of all peripheral vestibular sense organs is routine, the frequency of isolated loss of otolith function cannot be gauged.
近年来，前庭测试的进展使得对所有外周前庭感觉器官（三个半规管、椭圆囊和球囊）的功能测试成为可能。这使得我们能够识别出仅存在椭圆囊或球囊功能障碍的患者，尽管前庭信息的并行通路最终在中枢整合。在视频头脉冲测试（检查所有六个半规管）发现患者的半规管功能正常、双侧球囊功能正常的情况下，通过眼震电图前庭诱发肌源性电位（VEMP）可以观察到选择性、孤立性单侧椭圆囊功能丧失。本文讨论了这些患者的临床表现和恢复情况，并与急性前庭神经炎进行了对比。在一些患者中，单侧的耳石器官（椭圆囊或球囊）功能丧失持续存在，但患者的功能恢复到了他们通常的生活方式。在对所有外周前庭感觉器官进行常规测试之前，无法评估孤立性耳石功能丧失的频率。
