Zhang Xueqing, Deng Qiaomei, Liu Qiang, Wen Chao, Wang Wei, Chen Taisheng
Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China.
Institute of Otolaryngology of Tianjin, Tianjin, China.
Front Neurosci. 2022 Aug 24;16:957617. doi: 10.3389/fnins.2022.957617. eCollection 2022.
The characteristics of horizontal and vertical components of nystagmus evoked by the supine roll test in patients with horizontal semicircular canal canalolithiasis (HSC-Can) were analyzed, according to Ewald's first law. It provided a basis for the study of human horizontal semicircular canal function and structure, objective diagnosis, and treatment of benign paroxysmal positional vertigo (BPPV).
The records of patients that had been tested with 2-dimensional videonystagmography (2D-VNG) were reviewed between June 2019 and June 2021. The intensity and direction of horizontal and vertical nystagmus elicited by the supine roll test were analyzed in 189 patients with idiopathic HSC-Can.
All the 189 patients with HSC-Can were induced horizontal nystagmus with the same direction as head-turning (geotropic) in the supine roll test, of which 119 patients (63.96%) had a weak vertical upward component of nystagmus on the affected and unaffected sides, 57 patients (30.16%) had a vertical downward component of nystagmus on the affected side and/or the unaffected side, and 13 patients (6.88%) had no vertical component of nystagmus on both the sides. The intensity values of the horizontal component on the affected and unaffected sides were 42.14 ± 24.78 (range: 6.26-138.00°/s) and 17.48 ± 10.91°/s (range: 2.40-53.83°/s), with a ratio of 2.96 ± 2.17:1, representing a significant difference ( < 0.001). We analyzed the characteristics of horizontal and vertical components in 119 patients with HSC-Can (57 L-HSC-Can and 62 R-HSC-Can) on the supine roll test. The intensity values of the horizontal component on the affected and unaffected sides were 43.17 ± 23.76 (range: 8.60-124.51°/s) and 17.98 ± 10.99°/s (range: 2.40-53.83°/s), and the intensity values of the vertical component on the affected and unaffected sides were 10.65 ± 8.46 (range: 1.90-50.83°/s) and 4.81 ± 3.45°/s (range: 0.30-20.43°/s), representing a significant difference between groups ( < 0.001). Among 119 patients with HSC-Can who had a vertical upward component on both the affected and unaffected sides in the supine roll test, unilateral weakness (UW) was normal in 53 cases and abnormal in 51 cases, and 15 cases did not undergo the caloric test. We compared the horizontal and vertical components of nystagmus induced on the affected and unaffected sides in the supine roll test in 53 patients with normal UW and 51 patients with abnormal UW, and the difference was not statistically significant.
There is mostly a vertical upward component based on the horizontal component in HSC-Can, and the direction and intensity characteristics of nystagmus accord with Ewald's first law, which can provide a basis for the study of human HSC function and structure, objective diagnosis, and treatment of BPPV.
根据埃瓦尔德第一定律，分析水平半规管管结石症（HSC-Can）患者仰卧翻滚试验诱发的眼震水平和垂直成分的特征。为研究人类水平半规管功能与结构、良性阵发性位置性眩晕（BPPV）的客观诊断及治疗提供依据。
回顾2019年6月至2021年6月间接受二维视频眼震图（2D-VNG）检查患者的记录。分析189例特发性HSC-Can患者仰卧翻滚试验诱发的水平和垂直眼震的强度及方向。
189例HSC-Can患者在仰卧翻滚试验中均诱发与转头方向相同（地向性）的水平眼震，其中119例（63.96%）患侧和未患侧眼震有微弱的垂直向上成分，57例（30.16%）患侧和/或未患侧眼震有垂直向下成分，13例（6.88%）双侧均无眼震垂直成分。患侧和未患侧水平成分的强度值分别为42.14±24.78（范围：6.26 - 138.00°/s）和17.48±10.91°/s（范围：2.40 - 53.83°/s），比值为2.96±2.17:1，差异有统计学意义（<0.001）。我们分析了119例HSC-Can患者（57例左HSC-Can和62例右HSC-Can）仰卧翻滚试验中水平和垂直成分的特征。患侧和未患侧水平成分的强度值分别为43.17±23.76（范围：8.60 - 124.51°/s）和17.98±10.99°/s（范围：2.40 - 53.83°/s），患侧和未患侧垂直成分的强度值分别为10.65±8.46（范围：1.90 - 50.83°/s）和4.81±3.45°/s（范围：0.30 - 20.43°/s），组间差异有统计学意义（<0.001）。在119例仰卧翻滚试验患侧和未患侧均有垂直向上成分的HSC-Can患者中，53例单侧眼震减弱（UW）正常，51例异常，15例未进行冷热试验。我们比较了53例UW正常和51例UW异常患者仰卧翻滚试验中患侧和未患侧诱发眼震的水平和垂直成分，差异无统计学意义。
HSC-Can中大多在水平成分基础上有垂直向上成分，眼震方向和强度特征符合埃瓦尔德第一定律，可为研究人类HSC功能与结构、BPPV的客观诊断及治疗提供依据。
