Demanez J P
Acta Otorhinolaryngol Belg. 1986;40(5):695-858.
This report deals with what is to be known in applying ENG in the everyday office. From vestibular, visual and proprioceptive informations central neural processing evolve to stabilize images on the retina. ENG can perform an analysis of these systems, alone or interacting. Anatomical, neurophysiological backgrounds and experimental pathophysiology results are first described. The methodic rule of anamnesis is emphasized and the non instrumental examination is outlined. Concerning the technical aspects and the ENG achievement, some nonlinearities are stressed. Next, procedure of eye movements recording, oculomotor and vestibular testing are described. Alertness, stimulation order, gaze direction and drugs influence the response. The nystagmus responses are evaluated by quantitative parameters and morphological aspects. The variability of these implies the multiplication of the pathological arguments. Peripheral vestibular disturbances lead to labyrinthine paresis or paralysis and to nystagmus directional preponderance, sometimes alone, often combined. Thermic predominance may be associated and cause of some interpretation difficulty. Diagnosis of central neurological disturbances is submitted to four conditions: only specific criteria selection; complete oculomotor and vestibular testing; graduated conclusions in function of the criteria number; no etiological but only functional or topographical diagnosis. Central vestibular syndromes lead also to labyrinthine weakness or nystagmus directional preponderance but, first at all, to specific criteria who are: saccadic, pursuit and horizontal optokinetic abnormalities, central spontaneous or positional nystagmus, failure of fixation suppression, hyperreflexia, perverted nystagmus, slowing of the nystagmus fast phases, slowing-down of the nystagmus slow phases, anisonystagmus, vertical optokinetic deficits and retraction nystagmus. Finally, these dysfunctions incidence in personal observations with some multi or unifocal central pathologies is described and the correspondent more characteristic findings are outlined.
本报告探讨了在日常临床工作中应用眼震电图（ENG）的相关知识。来自前庭、视觉和本体感觉的信息经中枢神经处理后，可使视网膜上的图像保持稳定。ENG能够单独或综合分析这些系统。首先描述了解剖学、神经生理学背景及实验病理生理学结果。强调了问诊的方法规则，并概述了非仪器检查。关于技术方面和ENG的成果，着重介绍了一些非线性问题。接下来，描述了眼动记录、动眼神经和前庭测试的过程。警觉性、刺激顺序、注视方向和药物都会影响反应。通过定量参数和形态学方面来评估眼震反应。这些反应的变异性意味着病理依据的增多。外周前庭功能障碍可导致迷路性轻瘫或麻痹以及眼震方向优势，有时单独出现，常合并存在。热优势可能与之相关，会造成一些解释上的困难。中枢神经系统功能障碍的诊断需满足四个条件：仅选择特定标准；进行全面的动眼神经和前庭测试；根据标准数量得出分级结论；不进行病因诊断，仅进行功能或定位诊断。中枢前庭综合征也会导致迷路性无力或眼震方向优势，但首先会出现特定标准，包括：扫视、跟踪和水平视动异常、中枢性自发性或位置性眼震、注视抑制失败、反射亢进、异常眼震、眼震快相减慢、眼震慢相减慢、不对称眼震、垂直视动缺陷和退缩性眼震。最后，描述了这些功能障碍在一些多灶性或单灶性中枢病变个人观察中的发生率，并概述了相应的更具特征性的发现。
