ENT Institute and Otorhinolaryngology Department, Affiliated Eye and ENT Hospital, Fudan University, Fenyang Road No. 83, Shanghai 200031, China.
Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China.
Am J Otolaryngol. 2021 Jul-Aug;42(4):102967. doi: 10.1016/j.amjoto.2021.102967. Epub 2021 Feb 17.
Horizontal nystagmus can be observed in the acute stage of vestibular neuritis, Although the direction of the nystagmus is gravity independent, its intensity can be influenced by gravity. In this study, we compared the slow phase velocity (SPV) of horizontal nystagmus in different head positions in patients with vestibular neuritis to analyze the static effects of gravity on horizontal nystagmus.
The study enrolled 22 vestibular neuritis patients with spontaneous horizontal nystagmus (9 men, 13 women; median age 40 years). The deficits were right-sided in 9 patients and left-sided in 13. The nystagmus was recorded in the sitting, supine, right and left ear down positions. The intensity of spontaneous nystagmus in the sitting versus while supine position, and SPV in affected ear down (AED), healthy ear down (HED), and supine positions were compared. The position-induced nystagmus was calculated to quantify the effect of head positions on nystagmus.
The nystagmus intensity in the supine position had no statistic difference than when sitting, with a median value of 6.3°/s and 5.6°/s, respectively(P = 0.355). SPV in AED had a median value of 7.8°/s, which was greater than when supine (P = 0.008) and HED (4.8°/s) (P < 0.001). Position-induced nystagmus in left and right ear-down positions were 1.4°/s and -1.4°/s respectively, which were significantly correlated (Spearman's ρ = -0.848, P < 0.001).
The nystagmus intensity in vestibular neuritis is gravity dependent; it's greater in AED than in supine and HED, and the effect of head position on nystagmus was nearly symmetrical in left and right ear-down positions.
前庭神经炎急性期可观察到水平性眼震，尽管眼震的方向不受重力影响，但强度可受重力影响。本研究比较了前庭神经炎患者在不同头位时水平眼震的慢相速度（SPV），以分析重力对水平眼震的静态影响。
本研究纳入了 22 例伴有自发性水平眼震的前庭神经炎患者（9 例男性，13 例女性；中位年龄 40 岁）。其中 9 例为右侧病变，13 例为左侧病变。患者分别处于坐位、仰卧位、右侧和左侧卧位时记录眼震，比较坐位与仰卧位时自发性眼震的强度，以及患侧耳低位（AED）、健侧耳低位（HED）和仰卧位时的 SPV。通过计算位置诱导性眼震来量化头位对眼震的影响。
仰卧位眼震强度与坐位相比无统计学差异，中位数分别为 6.3°/s 和 5.6°/s（P=0.355）。AED 的 SPV 中位数为 7.8°/s，大于仰卧位（P=0.008）和 HED（4.8°/s）（P<0.001）。左侧和右侧耳低位的位置诱导性眼震分别为 1.4°/s 和-1.4°/s，两者呈显著相关（Spearman ρ=-0.848，P<0.001）。
前庭神经炎患者的眼震强度受重力影响；AED 时大于仰卧位和 HED，左侧和右侧耳低位对眼震的影响几乎对称。
