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内淋巴积水延迟患者冷热试验与视频头脉冲试验的分离

Dissociation of Caloric and Video Head Impulse Tests in Patients With Delayed Endolymphatic Hydrops.

作者信息

Leng Yangming, Liu Bo

机构信息

Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Front Neurol. 2020 May 12;11:362. doi: 10.3389/fneur.2020.00362. eCollection 2020.

Abstract

Delayed endolymphatic hydrops (DEH) represents a rare clinical entity characterized by intermittent vertigo attacks mimicking those of Ménière's disease (MD) in a patient with a prior sensorineural hearing loss. Some vestibular tests have been employed in patients with DEH. These tests provide useful diagnostic information and facilitate clinical decision-making. Here, we retrospectively studied the features of video head impulse test (vHIT) and examined its relationship with caloric test used in DEH patients. Included in this study were 17 patients with ipsilateral DEH and 2 with contralateral DEH. Among them, 73.7% (14/19) showed abnormal caloric test response (76.5% in ipsilateral DEH and 50% in contralateral DEH). Meanwhile, only 15.8% (3/19) of patients yielded abnormal horizontal vHIT results (11.8% in ipsilateral DEH and 50% in contralateral DEH). Abnormal caloric response in the presence of a preserved vHIT was common in DEH patients, especially those with ipsilateral DEH. This dissociation might be a distinctive pattern of vestibular deficit in DEH.

摘要

迟发性内淋巴积水(DEH)是一种罕见的临床病症,其特征为在既往存在感音神经性听力损失的患者中出现类似梅尼埃病(MD)的间歇性眩晕发作。一些前庭测试已应用于DEH患者。这些测试提供了有用的诊断信息并有助于临床决策。在此,我们回顾性研究了视频头脉冲测试(vHIT)的特征,并检查了其与DEH患者中使用的冷热试验的关系。本研究纳入了17例同侧DEH患者和2例对侧DEH患者。其中,73.7%(14/19)的患者冷热试验反应异常(同侧DEH患者中为76.5%,对侧DEH患者中为50%)。同时,仅15.8%(3/19)的患者水平vHIT结果异常(同侧DEH患者中为11.8%,对侧DEH患者中为50%)。在vHIT正常的情况下出现异常冷热反应在DEH患者中很常见,尤其是同侧DEH患者。这种分离可能是DEH前庭功能障碍的一种独特模式。

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