儿童复发性眩晕的前庭诱发肌源性电位的临床特征。
Clinical characteristics of vestibular evoked myogenic potentials in children with recurrent vertigo of childhood.
机构信息
Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, China; Shanghai Jiaotong University School of Medicine Ear Institute, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, China.
Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, China; Shanghai Jiaotong University School of Medicine Ear Institute, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, China.
出版信息
Int J Pediatr Otorhinolaryngol. 2022 Oct;161:111257. doi: 10.1016/j.ijporl.2022.111257. Epub 2022 Aug 7.
OBJECTIVE
To explore the possible pathogenesis of recurrent vertigo of childhood (RVC) and the clinical diagnosis value of vestibular-evoked myogenic potentials (VEMPs).
METHODS
The clinical data of 19 children (5.95 ± 0.38 years) diagnosed with RVC and 17 normal children (5.35 ± 0.31 years) enrolled in the control (NC) group from April 2017 to February 2021 was collected and analyzed. All subjects were tested for both cervical VEMP (cVEMP) and ocular VEMP (oVEMP). The elicit rate, thresholds, N1 latency, P1 latency, interval, amplitude, and amplitude asymmetry ratio (AAR) of VEMPs were compared and analyzed between the two groups.
RESULTS
(1) The elicit rates of cVEMP and oVEMP have no significant difference between the two groups (P > 0.05). (2) The thresholds of cVEMP and oVEMP in the RVC group were higher than that in the NC group (P < 0.05). (3) The N1 latency of cVEMP in the RVC group was longer than that in the NC group (P < 0.05). The P1 latency of cVEMP and latencies of oVEMP have no significant difference between the two groups (P > 0.05). (4) The interval of cVEMP in the RVC group was longer than that in the NC group (P < 0.05), while the interval of oVEMP has no significant difference between the two groups (P > 0.05). (5) The amplitude of cVEMP in the RVC group was higher than that in the NC group (P < 0.05), while the amplitude of oVEMP was similar in the two groups (P > 0.05). (6) The AAR values of oVEMP and cVEMP were similar in the two groups (P > 0.05).
CONCLUSIONS
The elicit rates of VEMPs in children with RVC did not differ from that of normal children, but the thresholds were all increased, suggesting reduced sensitivity of the otolith organ and vestibular nerve conduction pathways. The P1 latency of cVEMP was normal in children with RVC, but N1 latency and interval of cVEMP were increased, we finally reached a conclusion that there might be potential impairment in the inferior vestibular nerve and the subsequent nerve conduction pathway in RVC.
目的
探讨儿童复发性眩晕（RVC）的可能发病机制及前庭诱发肌源性电位（VEMPs）的临床诊断价值。
方法
收集 2017 年 4 月至 2021 年 2 月我院收治的 19 例（5.95±0.38 岁）RVC 患儿和 17 例正常儿童（5.35±0.31 岁）的临床资料进行回顾性分析。所有受试者均行颈肌前庭诱发肌源性电位（cVEMP）和眼肌前庭诱发肌源性电位（oVEMP）检测。比较并分析两组 VEMPs 的引出率、阈值、N1 潜伏期、P1 潜伏期、间期、振幅和振幅不对称比（AAR）。
结果
（1）两组 cVEMP 和 oVEMP 的引出率差异无统计学意义（P>0.05）。（2）RVC 组 cVEMP 和 oVEMP 的阈值均高于 NC 组（P<0.05）。（3）RVC 组 cVEMP 的 N1 潜伏期长于 NC 组（P<0.05）。cVEMP 的 P1 潜伏期和 oVEMP 的潜伏期差异无统计学意义（P>0.05）。（4）RVC 组 cVEMP 的间期长于 NC 组（P<0.05），而 oVEMP 的间期差异无统计学意义（P>0.05）。（5）RVC 组 cVEMP 的振幅高于 NC 组（P<0.05），而 oVEMP 的振幅在两组间相似（P>0.05）。（6）oVEMP 和 cVEMP 的 AAR 值在两组间相似（P>0.05）。
结论
RVC 患儿 VEMPs 的引出率与正常儿童无差异，但阈值均升高，提示耳石器官和前庭神经传导通路敏感性降低。RVC 患儿 cVEMP 的 P1 潜伏期正常，而 N1 潜伏期和间期延长，最终得出结论，RVC 患者可能存在下前庭神经及其后续神经传导通路的潜在损害。
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